Bronchogenic cyst has been recognized as remnants of foregut which abnormally were developed tracheobronchial tree during embryonic period. The anomaly was found in the lung or mediastinum but rarely in the neck. Histologic diagnosis can be made by the identification of the airway tissue lined by ciliated pseudostratified columnar or cuboid epithelium. A 4-year-old patient was admitted due to increase in the size of right neck mass which was incidentally found 2 years ago. In anterior triangle of neck, soft, non-tender and movable mass was presented in right lymph node measured by 1.2X0.7 cm in size. On admission, soft and non-tender mass was palpated at the right neck between right thyroid gland and right sternocleidomastoid muscle measured by 2.0x1.0 cm in size. After the excisional operation, histopathologic examination revealed the smooth muscle and muco-serous gland lined by ciliated pseudostratified columnar epithelium, and was diagnosed of bronchogenic cyst surrounded by enlarged lymph nodes which were reflecting reactive hyperplasia. We are reporting a case of bronchogenic cyst presenting as neck mass with brief review of the literature.
Bronchogenic Cyst* ; Child ; Child, Preschool* ; Diagnosis ; Epithelium ; Humans ; Hyperplasia ; Lung ; Lymph Nodes ; Male* ; Mediastinum ; Muscle, Smooth ; Neck* ; Thyroid Gland

The metastasis of uterine leiomyosarcoma to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiomyosarcoma, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiomyosarcoma.
Carboplatin ; Deglutition ; Drug Therapy* ; Leiomyosarcoma* ; Lymphatic Diseases* ; Neck ; Neoplasm Metastasis ; Paclitaxel ; Radiotherapy* ; Spinal Canal ; Spinal Cord Compression ; Spine

Simultaneous bilateral proximal femoral fractures are extremely rare, and a few have been reported in and outside the country. It may have various causes, and most cases were associated with major trauma, repetitive minor trauma, seizure, parathyroid or renal dysfunction, and anti-epileptic medications. We experienced a case of simultaneous bilateral proximal femoral fractures after generalized tonic-clonic seizure in a 70-year-old female. Herein, we report it with a review of the literature.
Aged ; Female ; Femoral Fractures ; Femur Neck ; Hip ; Hip Fractures ; Humans ; Seizures

OBJECTIVE: This study aimed to investigate the neurocognitive functions of patients with late-life depression compared to healthy controls and their association with improvement of depressive symptoms. METHODS: We compared the results of neurocognitive tests between 41 patients with late-life depression and 20 healthy controls at baseline and 3 months later prospectively. And then we investigated the association of change of cognitive function and improvement of depressive symptoms in patients with late-life depression. RESULTS: Patients with late-life depression showed significantly impaired results in neurocognitive tests especially in domains of language, memory and frontal executive function compared to healthy control. However, after 3 months of treatment of depression, there was no association between the change of results of neurocognitive tests and the changes of scores of Hamilton Depression Rating Scale (HAM-D). CONCLUSION: Impairment of cognitive functions in late-life depression includes the domains of language, memory and executive function and after 3 months of treatment of depression, there was no association of improvement of depressive symptom and cognitive change in patients with late-life depression.
Aged* ; Cognition ; Depression* ; Executive Function ; Follow-Up Studies* ; Humans ; Memory ; Prospective Studies

PURPOSE: This study was undertaken to retrospectively evaluate white blood cell kinetics, especially lymphocyte depression after different treatments, and to find the correlation between immunosuppression and large blood volume and dynamic blood flow within the mediastinal radiotherapy (RT) field in lung cancer. MATERIALS AND METHODS: Thirty-four patients with lung cancer were retrospectively evaluated; 10 patients had only radiotherapy (RT group), 8 had chemotherapy (CT group) and 16 had chemotherapy and radiotherapy (RT/CT group). The mean follow-up periods of the RT-including groups (RT group and RT/CT group) and the RT-excluding group (CT group) were 6 and 8 months, respectively. Complete blood cell counts including lymphocyte percentage (%) were checked weekly during RT but less frequently during CT and after RT. RESULTS: Changes in total white blood cell counts were not significantly different among the three groups. The lymphocyte count and lymphocyte % were much lower in the RT-including groups than in the RT- excluding group. The difference between pre-treatment and final lymphocyte count and the difference between pre-treatment and final lymphocyte % were significant (p=0.044 and p=0.037) between the RT- including groups and the RT-excluding group. CONCLUSION: Lymphopenia was more marked after treatment containing RT than CT only. Lymphopenia may be one cause of a compromised immune system after mediastinal irradiation in lung cancer. We suggest cautiously that previous studies showing evidence of lymphocyte apoptosis after low-dose irradiation and large blood volume and dynamic blood flow within the RT fields could be somewhat related to lymphopenia after mediastinal irradiation.
Apoptosis ; Blood Cell Count ; Blood Volume ; Depression ; Drug Therapy ; Follow-Up Studies ; Humans ; Immune System ; Immunosuppression ; Kinetics ; Leukocyte Count ; Leukocytes ; Lung Neoplasms* ; Lung* ; Lymphocyte Count ; Lymphocytes ; Lymphopenia* ; Radiotherapy ; Retrospective Studies

BACKGROUND: The aim of this study was to analyze the clinical manifestations and efficacy of treatment regimens in order to determine the adequate combination of anti-tuberculotic agent and duration of treatment for tuberculous lymphadenitis. METHODS: We made a review of 373 patients with tuberculous lymphadenitis, who were admitted to four medical college hospitals in Taegu Korea from 1989 to 1998, and their diagnoses were confirmed histologically and bacteriologically. RESULTS: The incidence of tuberculous lymphadenitis was 71.3% in women and 57.7% were between the ages of 20 and 39 years. The most common symptom was painless swelling. The most commonly involved lymph nodes were unilateral superficial cervical lymph node groups. Tuberculous lymphadenitis was accompanied with active pulmonary tuberculosis, commonly. The sensitivity of fine needle aspiration(FNA) in tuberculous lymphadenitis was 79.6% and 92.2% of the patients had a strong positive reaction to the tuberculin skin test. The most commonly prescribed anti-tuberculotic regimen was the combination of INF, RMP, EMB and PZA(62.6%). Eighty percent of patient were treated for 9-12 months. There was no significantly difference in the recurrence rate of tuberculous lymphadenitis between the combinations of anti-tuberculotic agent, including INF and RMP, and between the durations of treatment, for a period of 6 months of treatment, for a period of 6 months of more. CONCLUSION: The combination of FNA cytologic examination and tuberculin skin test may be helpful in the diagnosis of tuberculous lymphadenitis. We propose that the combination of anti-tuberculotic agents, INH, RMP, EMB, and PZA, be prescribed to patients for 6 to 9 months.
Daegu ; Diagnosis ; Female ; Humans ; Incidence ; Korea ; Lymph Nodes ; Needles ; Recurrence ; Skin Tests ; Tuberculin ; Tuberculosis, Lymph Node* ; Tuberculosis, Pulmonary

BACKGROUND: Because melanoma antigen gene (MAGE) was expressed in many kinds of cancers and MAGE expression is highly specific to cancer cells, MAGE has been studied as an important marker for cancer diagnosis. The purpose of this study was to evaluate the expression rates of MAGE-A1 to A6 by common MAGE primer and to evaluate the difference of expression rates of MAGE according to the clinical stages and the cell types in lung cancer tissues. METHODS: 114 cancer tissues (53 tissues surgically removed, 61 tissues bronchoscopically biopsied), 18 benign lung tissues and 45 normal lung tissues sampled from surgically removed lung cancer were investigated. The MAGE assay was performed by nested reverse transcription polymerase chain reaction (nested RT-PCR) using common MAGE primer. RESULTS: The expression rate of MAGE was 83.0% in surgically removed lung cancer tissues and was 70.5% in bronchoscopically biopsied lung cancer tissues. But MAGE was not detected in 18 benign lesions. In surgically removed lung cancer tissues, the positive rate of MAGE expression was 86.1% in squamous cell carcinoma, 69.2% in adenocarcinoma, and 100% in small cell carcinoma and in lung cancer tissues obtained by bronchoscopy 77.5%, 71.4%, and 50.0%, respectively. The detection rates of MAGE assay were increased according to clinical stage, stage I (57.1%), II (60.0%), III (80.0%) and IV (85.7%) (p>0.05). CONCLUSION: Common MAGE RT-PCR method is highly sensitive and specific for lung cancer detection. It may be useful method for the diagnosis of lung cancer and could be effectively utilized for early lung cancer screening method.
Adenocarcinoma ; Bronchoscopy ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Early Diagnosis ; Lung Neoplasms* ; Lung* ; Mass Screening ; Melanoma* ; Polymerase Chain Reaction ; Reverse Transcription

A 32-year-old woman was admitted to the hospital complaining of cough, sputum, and chest discomfort for the past ten days. The radiologic findings were transradiant left lung with reduced number and size of vessels, mediastinal shifting to the right at expiration, matched entilation-perfusion defect on ventilation-perfusion scan, and diffuse hypoplasia of the left pulmonary artery and its branches on pulmonary angiography. We describe a case of unilateral hyperlucent lung by main bronchus obstruction in a patient who presents with a clinical picture suggestive of Swyer-James syndrome.
Adult ; Angiography ; Bronchi* ; Cough ; Female ; Humans ; Lung ; Lung, Hyperlucent* ; Pulmonary Artery ; Sputum ; Thorax

Viral myocarditis is a inflammatory process of the heart caused by virus. Its manifestation ranges from asymptom to acute fulminent congestive heart failure and often mimics acute myocardial infarction. A 22 year old man was admitted to the hospital because of prolonged anterior chest pain. 15 days before entry, anterior chest pain with cough and fever brought him to the another hospital. At that time, the LDH level was 1160U/L, the CPK level was 659.7U/L and MB band was 16.1%. The ECG revealed acute inferior wall infarction. And 3 days later, extensive anterior wall infarction findings appeared. 2D-Echo findings showed proximal septal hypokinesia. On admission time to this hospital, physical examination was negative. The ECG showed no interval change. 2D-Echo findings showed increased echogenicity of anterior and inferior wall. Treadmill test did not evoked chest pain or change of ECG. The LDH, CPK levels returned to normal range. The antibody titers of Coxsackievirus type A-16 was positive. Coronary angiography showed normal findings. 3 months later, antibody's titer of Coxsackievirus A-16 was increased. A diagnosis of acute viral myocarditis was made.
Chest Pain ; Coronary Angiography ; Cough ; Diagnosis ; Electrocardiography ; Exercise Test ; Fever ; Heart ; Heart Failure ; Humans ; Hypokinesia ; Infarction ; Myocardial Infarction* ; Myocarditis* ; Physical Examination ; Reference Values ; Young Adult

BACKGROUND: The causes of solitary pulmonary nodule are many, but the main concern is whether the nodule is benign or malignant. Because a solitary pulmonary nodule is the initial manifestation of the majority of lung cancer, accurate clinical and radiologic interpretation is important. Bayes' theorem is a simple method of combining clinical and radiologic findings to estimate the probability that a nodule in an individual patients is malignant. We estimated the probability of malignancy of solitary pulmonary nodules with a specific combination of features by Byesian approach. METHOD: One hundred and eighty patients with solitary pulmonary nodules were identified from multi-center analysis. The hospital records of these patients were reviewed and patient age, smoking history, original radiologic findings, and diagnosis of the solitary pulmonary nodules were recorded. The diagnosis of solitary pulmonary nodule was established pathologically in all patients. We used to Bayes' theorem to devise a simple scheme for estimation the likelihood that a solitary pulmonary nodule is malignant based on radiological and clinical characteristics. RESULTS: In Patients characteristics, the probability of malignancy increases with advancing age, peaking in patients older than 66 year of age(LR : 3.65), and higher in patients with smoking history more than 46 pack years(LR : 8.38). In radiological features, the likeklihood ratios were increased with increasing size of the nodule and nodule with lobulated or spiculated margin. CONCLUSION: In conclusion, the likelihood ratios of malignancy may improve the accuracy of the probability of malignancy, and can be a guide of management of solitary pulmonary nodule.
Diagnosis ; Hospital Records ; Humans ; Lung Neoplasms ; Smoke ; Smoking ; Solitary Pulmonary Nodule*