No abstract available.
Humans ; Hypoglycemia* ; Infant* ; Infant, Newborn* ; Iron*

We report a rare case of giant vascular eccrine spiradenoma (GVES) which developed in 56-yr-old Korean woman. It is a rare variant of eccrine spiradenoma (ES), which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic features. Histogenesis of GVES is not clearly elucidated although it is known that ES presumably originates in the eccrine glands. To clarify the histogenesis of GVES, immunohistochemical stainings using various monoclonal antibodies were also performed. The tumor was composed of three types of cells, namely pale epithelial cells, small basal cells, and myoepithelial cells. Therefore, we conclude that GVES originated from eccrine gland and mainly differentiates toward secretory portion of secretory coil.
Actins/analysis ; Adenoma, Sweat Gland/blood supply/metabolism/*pathology ; Biological Markers/analysis ; CA-15-3 Antigen/analysis ; Eccrine Glands/blood supply/chemistry/*pathology ; Female ; Humans ; Immunohistochemistry ; Keratin/analysis ; Korea ; Membrane Proteins/analysis ; Middle Aged ; Muscle, Smooth/chemistry ; Sweat Gland Neoplasms/blood supply/metabolism/*pathology

No abstract available.
Copper* ; Female ; Humans ; Intrauterine Devices*

Fat embolism syndrome is a rare clinical diagnosis of dyspnea with acute respiratory failure and neurological signs caused by a traumatic long bone fracture. We report a case of fat embolism in a 22 year-old man after a traffic accident. Dyspnea and stuporous mental changes developed on the 1st day after the external fixation operation of a left metaphyseal femur fracture. On the following day, he was transferred from a hospital to this one because of acute respiratory failure. After recovery, macrophages with fat droplets were found in the bronchoalveolar lavage fluid 1. It is important to diagnose a fat embolism as the correct cause of acute respiratory failure through the BAL in the acute state of fat embolism syndrome It is believed that clinically apparent or sometimes hidden fat embolism syndrome can be diagnosed from the BAL during the recovery state.
Accidents, Traffic ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Diagnosis ; Dyspnea ; Embolism, Fat* ; Femur ; Fractures, Bone ; Humans ; Macrophages ; Respiratory Insufficiency* ; Stupor ; Young Adult

Langerhans' Cell Histiocytosis(LCH) is a disease of unknown origin, characterized by abnormal proliferation of Langerhans' cells. Previously, it has been called histiocytosis X, which included eosinophilic granuloma, Hand-Sch ller-Christian's disease, and Letterer-Siwe disease. Any organs or tissues such as skin, lymph nodes, bone and bone marrow can be involved. However, LCH of chest wall is rarely reported in our country. We experienced a 18 month old male child, who had osteolytic lesion involving the rib with axillary lymph node metastasis. The tumor was confirmed as LCH after surgery.
Bone Marrow ; Child ; Eosinophilic Granuloma ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Infant ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Ribs ; Skin ; Thoracic Wall* ; Thorax*

PURPOSE: In the treatment of advanced metastatic colorectal cancer, several new agents, such as irinotecan and oxaliplatin, have been developed, which have improved both disease free and overall survivals. Among these agents, 5-fluorouracil (5-FU) still remains one of the most active agents, and the selection of patients who can benefit from 5-FU-based chemotherapy is still important, as those unlikely to benefit could be spared the harmful side effects. The expression levels of thymidylate synthase (TS), thymidine phosphorylase (TP) and p53 have been known to be associated with the clinical response to 5-FU-based therapy as well as the prognosis, and that of vascular endothelial growth factor (VEGF) is associated with poor survival. MATERIALS AND METHODS: The relationship between the expressions of TS, TP, VEGF and p53 in primary tumors, using immunohistochemistry, and the response of 45 metastatic colorectal cancer patients (M: F=25: 20, median age 59 yrs) to 5-FU-based chemotherapy were evaluated. RESULTS: Thirty-seven patients were treated with 5-FU/ LV/irinotecan (FOLFIRI) and 8 with 5-FU/LV/oxaplatin (FOLFOX). The overall response rate was 28.9% (13/45). When immunohistochemically analyzed with monoclonal antibodies against TS, TP, VEGF and p53, 55.6% of the patients (25/45) were positive for TS, 48.9% (22/45) for TP, 82.2% (37/45) for VEGF, and 80% (36/45) for p53. There was a significant difference in the intensity of TS expression between the clinical responders and non-responders (p=0.036). In terms of the staining pattern of TS expression, diffuse staining was correlated with a poor response (p=0.012) and poor survival (p=0.045). However, there was no correlation between the expressions of TP, VEGF or P53 and the response to chemotherapy. CONCLUSION: These results suggest that the expression of TS in primary colorectal cancer might be an important prognostic factor for chemotherapy response and survival, and might be a useful therapeutic marker for the response of chemotherapy.
Antibodies, Monoclonal ; Colorectal Neoplasms* ; Drug Therapy* ; Fluorouracil ; Humans ; Immunohistochemistry ; Prognosis ; Thymidine Phosphorylase* ; Thymidine* ; Thymidylate Synthase* ; Vascular Endothelial Growth Factor A*

PURPOSE: To raise awareness of the clinical importance of, and the need for proper management of acute focal bacterial nephritis(AFBN), we analyzed 22 AFBN patients and 22 other upper urinary tract infection patients by use of comparative studies. METHODS: From January 2000 to May 2002, 22 AFBN patients aged from 1 month to 12 months were selected. As a control group, 22 UTI patients with no radiologic abnormalities were selected and matched by age and sex. RESULTS: The incidence of AFBN was more common in boys than in girls. Since both groups had similar symptoms, it was difficult to diagnose AFBN by clinical presentations alone. ESR and CRP were significantly higher in AFBN patients. The most common causative organism was E. coli in both groups. On the sonographic findings, the most lesions were seen on the upper lobe of the kidney; more frequently, on left kidney. The lesions showed globular or wedge-shaped increased echogenecity. 99mTc-DMSA scan showed the complete coincidence of the location, size and shape in all cases compared to the findings of renal sonography. CONCLUSION: The roles of renal sonography and DMSA scan were very important, and ultrasonography was an excellent initial tool in diagnosing AFBN. Since the degree of infection in AFBN is more severe than other urinary tract infections and evollution into a renal abscess is possible, early diagnosis and appropriate antibiotics therapy is essential.
Abscess ; Anti-Bacterial Agents ; Child* ; Early Diagnosis ; Female ; Humans ; Incidence ; Kidney ; Nephritis* ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Urinary Tract Infections

BACKGROUND: Basal cell carcinoma(BCC) does not commonly occur in dark-skinned people, although it is the most common cancer of light-skinned people. So it has been known that incidence of BCC is lower than that of squamous cell carcinoma(SCC) in Asian and Africans. However, several recent Korean articles have reported the reversal of the ratio of SCC to BCC. There has been no report about BCC following a nationwide survey in Korea. OBJECTIVE: Our purpose was to confirm the trends in BCC and SCC, and to identify the clinical and histopathological characteristics of BCC. METHODS: A clinical and histopathological analysis was done retrospectively with patients diagnosed as BCC from the Department of Dermatology of 15 University Hospitals or General Hospitals during the last 20 years(1977-1996). Annual incidence of BCC was compared with that of SCC at the same situation. We compared the results with those in other races statistically. RESULTS: 1. Incidence of BCC was 0.16% compared with 0.11% of SCC. The increasing incidence of BCC was more pronounced than that of SCC, although they were increased gradually. 2. The male-female ratio was 1:1.07, and the most frequent age group was the 6th decade(30.1%). 95% of the patients were older than the age of 40 years with the mean age of 62.7 years. 3. The most commonly involved site was the face(84.9%), especially on the nose, cheek, and eyelids. 4. The most frequent histologic pattern was nodulocystic type(35.4%), followed by mixed(30.1%), infiltrative(9.3%), superficial(6.7%), micronodular(6.2%), adenoid(5.9%), metatypical(4.0%), morpheaform(2.1%), and fibroepithelioma type(0.3%). 5. Histologically, 45.3% of BCC contained pigment. The histologic pattern most frequently associated with pigmented BCC was mixed type(53.1%) followed by nodulocystic(51.2%), superficial(46.8%), micronodular(38.6%), and adenoid type(33.3%). 6. Overall recurrence rate was 6.3%. Morpheaform, infiltrative, and metatypical BCC have a high erincidence of recurrence(26.3%, 13.2%, 8.1%, respectively). Therapeutic modalities that showed high recurrence rate was 5-FU, curettage and electrodessication, and cryotherapy(33.3%, 28.6%, 16.8%, respectively). CONCLUSION: It was confirmed following a nationwide survey that increasing incidence of BCC was more pronounced than that of SCC since early 1980s and BCC was the most common skin cancer in Korea.
Adenoids ; Asian Continental Ancestry Group ; Carcinoma, Basal Cell* ; Cheek ; Continental Population Groups ; Curettage ; Dermatology ; Eyelids ; Fluorouracil ; Hospitals, General ; Hospitals, University ; Humans ; Incidence ; Korea ; Nose ; Recurrence ; Retrospective Studies ; Skin Neoplasms

BACKGROUND AND OBJECTIVES: Metal allergy has been reported to be related to stent restenosis. Therefore, we sought to investigate the incidence of metal allergy with new carbon stent with ion implantation technique and its relationship to restenosis. SUBJECTS AND METHODS: Between April 2002 and June 2004, 128 patients (100 male, mean age 60+/-10 years) were included in this study. The clinical diagnoses of the study patients included 64 acute myocardial infarction, 24 unstable angina and 40 stable angina patients. Patients were randomly assigned to receive either an Arthos Inert Stent (the study group) or an Arthos stent (the control group), with follow-up angiography scheduled 6 months later. Three months after stent implantation, skin patch tests, for the detection of metal allergies, were performed with manganese, molybdenum, nickel and chromium. RESULTS: There were no differences between the age, genders, risk factors and multi-vessel involvement between the two groups, as well as no differences in the angiographic parameters and restenosis (p>0.05). There were no differences in the positive rates of the skin tests between the Arthos stent and Arthos Inert stent groups or between the restenosis and no-restenosis groups (p>0.05). CONSLUSION: The new carbon stent, with ion implantation, did not reduce coronary restenosis. An allergic reaction was not related to the stent technology or stent restenosis.
Angina, Stable ; Angina, Unstable ; Angiography ; Carbon* ; Chromium ; Coronary Artery Disease ; Coronary Restenosis ; Diagnosis ; Follow-Up Studies ; Humans ; Hypersensitivity* ; Incidence ; Male ; Manganese ; Molybdenum ; Myocardial Infarction ; Nickel ; Patch Tests ; Risk Factors ; Skin ; Skin Tests ; Stents*

Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.