No abstract available.
Diagnosis* ; Echocardiography*

BACKGROUND: Hemoptysis is a common clinical symptom, responsible for 11% of admission to the hospital chest service. Correct diagnosis, accurate localization of the bleeding source and proper management are imperative to reduce the risk of massive hemoptysis. We performed the study to define the optimal time of fiberoptic bronchoscopy in 63 patients with hemoptysis admitted to Kyung Hee University Hospital between Aug 1989 and Aug1992. METHODS: Retrospective analysis of medical records concerning the cause, amount, duration of hemoptysis and the timing of fiberoptic bronchoscopy in 63(M:F=36:27) patients. RESULTS: 1) The main causes of hemoptysis were pulmonary tuberculosis(52.4%) bronchiectasis(27.0%) and lung cancer(11.1%). 2) The bleeding sites were localized in 26 Patients(41.3%). 3) The rates of localization of bleeding site were not related to the amount and duration of hemoptysis. 4) The rates of localization of bleeding site were 61.8%(21/34) during hemoptysis,18.2%(122) within 24hr after resolution of hemoptysis, 14.3%(1/7) thereafter. CONCLUSION: Early bronchoscopy, especially during hemoptysis may show higher rates of successful localization than delayed bronchoscopy.
Bronchoscopy* ; Diagnosis ; Hemoptysis* ; Hemorrhage* ; Humans ; Lung ; Medical Records ; Retrospective Studies ; Thorax

No abstract available.
Free Tissue Flaps* ; Lower Extremity*

We recently treated an infant with abnormal calcification in the soft tissues of the wrist and hand caused by an intravenous injection of calcium gluconate for treatment of neonatal hypocalcemia. The cause of the soft tissue calcifications was quite puzzling, if the incident of calcium gluconate extravasation had been overlooked, because the lesions mimicked for cellulitis or abscesses and treated as such. All radiographic evidence of calcification gradually resorbed by conservative management.
Abscess ; Calcium Gluconate ; Calcium ; Cellulitis ; Hand ; Humans ; Hypocalcemia ; Infant ; Infant, Newborn ; Injections, Intravenous ; Wrist

PURPOSE: Acute promyelocytic leukemia (APL or AML, M3) represents an unique model for cancer research in terms of biological and clinical features. Since 1988, it has been widely confirmed that all-trans retinoic acid (ATRA) can induce complete clinical remission in over 85% of APL patients by a differentiation process, with PML-RARalpha protein possibly being the direct target of ATRA. However, ATRA treatment has two clinical limitations, namely, retinoic acid syndrome and retinoic resistance. Recently, it has been shown that arsenic trioxide used in some traditional Chinese remedy is very effective in retinoic resistant APL treatment. We tried to observe arsenic effect on cell lines and APL patient cells. MEHTODS: We investigated arsenic trioxide-induced apoptosis on APL, HL60, K562, KPH1 cell lines through MTT assay, DNA fragmentation assay and morphologic features. RESULTS: In MTT assay, cell survival rate decreased as the concentration of arsenic trioxide increased. In DNA fragmentation assay with HL60 cell line, DNA fragmentation was more frequent in high concentrations of arsenic trioxide than in low concentrations. During arsenic trioxide treatment, the morphologic change in bone marrow cells of APL patient, included nuclear differentiation and dark cytoplasmic granule during arsenic trioxide treatment. Serum arsenic reached peak level at 4hr after injection. We experienced a case of a 9-year-old male with APL who had relapsed after cessation of retinoic acid treatment. The patient successfully achieved remission following arsenic trioxide treatment without bone marrow depression and exacerbating bleeding diathesis. CONCLUSION: Arsenic trioxide can be used effectively to treat APL patients by inducing apoptosis and partial differentiation in tumor cells. The precise cellular and molecular mechanisms of its therapeutic effects remain to be determined.
Apoptosis ; Arsenic* ; Asian Continental Ancestry Group ; Bone Marrow ; Bone Marrow Cells ; Cell Line ; Cell Survival ; Child ; Cytoplasmic Granules ; Depression ; Disease Susceptibility ; DNA Fragmentation ; Hemorrhage ; HL-60 Cells ; Humans ; Leukemia, Promyelocytic, Acute* ; Male ; Tretinoin

PURPOSE: Percutaneous transluminal angioplasty(PTA) with a balloon catheter is a standard method of treatment for membranous obstruction of inferior vena cava(MOIVC). But, correct therapeutic approach has not been established for MOIVC patients whose lesion is associated with extensive thrombotic IVC occlusion. We tried to treat MOIVC associated with or without thrombus. MATERIALS AND METHODS: We treated 13 cases of MOIVC(associated with thrombus in 7 cases, no thrombus in 6 cases) with PTA, thrombolysis and self-expandable metallic stents. RESULTS: PTA was successful in 8 cases, but failed in 5 cases. The recurred cases were retreated with PTA, but follow up study revealed recoiling restenosis in 4 cases and intimal hyperplasia in 1 case at previous PTA site which could be overcome with a self-expandable metallic stent. The complication were occurred in 3 cases which were hemothorax, hemopericardium, and hemoperitoneum respectively. However, those were resolved by conservative treatment only. CONCLUSION: Recanalization and dilatation could be done in MOIVC patients with or without thrombosis for improvement of patient's symptom. Gianturco self-expandable metallic stent is sueful in treatment of recurred MOIVC after balloon dilatation and preventing reocclusion of the IVC after PTA.
Catheters ; Dilatation ; Follow-Up Studies ; Hemoperitoneum ; Hemothorax ; Humans ; Hyperplasia ; Pericardial Effusion ; Stents* ; Thrombosis

OBJECTIVES: Manganese is cytotoxic to the central nervous system including basal ganglia. Its toxic mechanism is related to oxidative stress, mediated by toxic free radicals but is specultives. In the present study, we have investigated to manifest apoptosis in manganese-induced cytotoxicity in primary neuronal cell culture of rat basal ganglia. METHOD: To detect apoptotic neuronal cells were stained by the terminal deoxynu-cleotide(TdT)-mediated dUTP nick end-labelling(TUNEL) method and apoptotic changes in nuclei of neurons were observed by electron microscopy. RESULTS: We showed that TUNEL immunostain showed brownish signal in the nuclei of apoptotic cells and the proportions of apoptotic cells in Manganese treatment groups were more higher than controls. On transmission electron microscopy, there were chromatine condensation with margination toward nuclear membrane and condensation of cytoplasm in the treated with luM MnC1, for 48 hours in a basal ganglia neurons. Apoptotic bodies were found and consisted of semilunar-like condensed nuclei with relatively intact cytoplasmic organelles. CONCLUSIONS: Apoptosis appears to be one mechanism in the manganese-induced neuronal cell death. Manganese intoxication is a convenient model for apoptosis study.
Animals ; Apoptosis* ; Basal Ganglia* ; Cell Culture Techniques* ; Cell Death ; Central Nervous System ; Chromatin ; Cytoplasm ; Free Radicals ; In Situ Nick-End Labeling ; Manganese* ; Microscopy, Electron ; Microscopy, Electron, Transmission ; Neurons* ; Nuclear Envelope ; Organelles ; Oxidative Stress ; Rats

We report herein a case of primary cutaneous diffuse large B-cell lymphoma with multiple skin lesions in a Korean woman. A 56-year-old woman presented with rapidly growing multiple sub-cutaneous nodules in her right flank and right upper arm. Microscopic examination of skin biopsy specimen showed diffuse infiltrates of large atypical lymphocytes with vesicular nuclei, prominent nucleoli and moderate degree of mitotic figures in deep dermis and subcutis. Immunophenotypic studies revealed the lymphoid infiltrates reacted with CD45, CD20 and bcl-2 protein, but none of the sections expressed CD3, bcl-6 protein and CD30. In physical examination and staging work-up, we could not find any other extracutaneous or systemic involvement. She was treated with 2 cycles of high-dose multiagent chemotherapy with the Vanderbilt and the BEAM regimen combined with the autologous peripheral blood stem cell transplantation. Until now, 10 months after termination of treatment, she has shown improvement of all skin lesions and no development of extracutaneous disease.
Arm ; B-Lymphocytes* ; Biopsy ; Dermis ; Drug Therapy ; Female ; Humans ; Lymphocytes ; Lymphoma, B-Cell* ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; Physical Examination ; Skin

The hypoglossal nerve is a motor supply of the tongue. Hypoglossal nerve palsy after general anesthesia is rare but there have been several reports showing an association with oropharyngeal manipulation such as intubation, bronchoscopy, and laryngeal mask airway. The main mechanism considered has been a temporary compression of the nerve along its superficial course at the lateral root of the tongue during oropharyngeal manipulation. We encountered a patient who complained speaking and swallowing difficulties after general surgery. A deviation to the affected side, atrophy, and fasciculation of tongue were observed. Almost all palsies recovered spontaneously. We present a patient with a transient unilateral hypoglossal nerve palsy after an uncomplicated intubation and anesthesia for surgery for humerus fracture in the beach-chair position.
Anesthesia ; Anesthesia, General* ; Atrophy ; Bronchoscopy ; Deglutition ; Fasciculation ; Humans ; Humerus ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Intubation ; Laryngeal Masks ; Paralysis ; Tongue

Apocrine adenocarcinoma is rarely reported in the world and only 4 cases are reported in Korean literature. We encountered a case of apocrine adenocarcinoma associated with basal cell carcinoma in a 76-year-old female. Excisional biopsy showed well demarcated basophilic cell mass in the upper dermis and glandular structure in the lower dermis. Basophilic cell mass consisted with basaloid cells and had peripheral palisading arrangement. Glandular structures characterized by cells with abundant eosinophilic cytoplasm showed decapitation secretion. The cells showed nuclear atypicality, plemorphism and prominent nucleoli. The cytoplasm contained PAS-positive, diastase-resistant granules and stains for lysozyme and GCDFP-15(Gross Cystic Disease Fluid Protein-15) were positive.
Adenocarcinoma* ; Aged ; Basophils ; Biopsy ; Carcinoma, Basal Cell* ; Coloring Agents ; Cytoplasm ; Decapitation ; Dermis ; Eosinophils ; Female ; Humans ; Muramidase