We report a rare case of intrathoracic lymphangiomatosis associated with chylothorax in a 3-year-old boy. The patient had been healthy until he had chickenpox followed by continued dyspnea. The biopsy specimen showed proliferating lymphatic channels & spindle cells in the lung tissue. The boy died of respiratory failure despite conservative treatment and surgical treatment with pleurodesis. An autopsy was performed. Pleura and pericardium showed severe adhesion to the right lung parenchyma. The cut surface of lung showed thickened interlobular septum with honeycomb-appearance. Histologically, extensive intercommunicating and anastomosing endothelial-lined lymphatic channels were noted along the visceral and parietal pleura, pericardium, around the great vessels, and in the anterior mediastinum over the thymus. These lymphatic channels infiltrated into the pulmonary parenchyme along the bronchovascular bundles. There were scattered areas of spindle cell proliferation with extravasation of RBCs mimicking Kaposi's sarcoma. Histologic diagnosis and differential diagnosis on biopsy materials can be difficult to establish but awareness of the intrathoracic lymphangiomatosis and its various clinical presentation may be helpful for diagnosis.
Autopsy* ; Biopsy ; Cell Proliferation ; Chickenpox ; Child, Preschool ; Chylothorax ; Diagnosis ; Diagnosis, Differential ; Dyspnea ; Humans ; Lung ; Male ; Mediastinum ; Pericardium ; Pleura ; Pleurodesis ; Respiratory Insufficiency ; Sarcoma, Kaposi ; Thymus Gland

The posterior cruciate ligament in the stoutest ligamentous structure in the knee joint. Kennedy and Hawkins have confirmed its strenght to be about 2 times that of the anterior cruciate ligament or tibial collateral ligament. This would appear to offer the support that this ligament has a vital role to play in knee stabilization. But, in the past, non-surgical management was frequently elected either because of the belief that most kness with posterior cruciate insufficiency are asymptomatic or because it is difficult to access surgically. Recently, Hughston and Trickey reported good results after surgical repair of the rupture of the posterior cruciate ligament. And current trend is to repair it surgically. So, we analyzed the 36 cases of acute posterior cruciate ligament injuries, who were admitted and treated surgically in Severance Hospital between Jan. 1981 to Dec. 1985, and obtained the following results. 1. Single rupture of the posterior cruciate ligament largely results in good outcome. 2. When the rupture site is in the substane, we can obtain relatively good results with the augmentation using the medial head of the gastrocnemius. 3. When combined with medial or lateral compartment injuries, the chance of later instability and reconstruction is high.
Anterior Cruciate Ligament ; Clinical Study ; Head ; Knee ; Knee Joint ; Ligaments ; Medial Collateral Ligament, Knee ; Posterior Cruciate Ligament ; Rupture

No abstract available in English.
Blood Pressure ; Immobilization ; Orthopedics

BACKGROUND: Identification of specific antinuclear antibodies is useful for the diagnosis, subclassification and determination of prognosis in autoimmune disorders. In many diseases, multiple autoantibodies are detected, and simultaneous detection of multiple autoantibodies has been shown to be useful. Recently, a commercial kit (EL-ANA/6 profiles, TheraTest Laboratories, USA) losing enzyme-linked immunosorbent assay (ELISA) method for detection of six specific autoantibodies is avallable. In this study, we attempted to compare the results of EL-ANA/6 profiles with those of routinely used methods and evaluated usefulness of EL-ANA/6 profiles. METHODS: EL-ANA/6 profiles were performed with 28 sera which were positive for fluorescent antinuclear antibody (FANA) Simultaneously we tested anti-dsDNA antibodies with immnofluorescent (If) method and anti-Sm, anti-RNP, anti-SSA and anti-SSB antibodies with double immunodiffusion (DID). To evaluate specificity, EL- ANA/6 profiles tests were performed on 10 sera from healthy blood donors. RESULTS: Ten sera of healthly blood donors were all negative for EL-ANA/6 pro biles. In the results of EL-ANA/6 profiles on sera positive for FANA, the concordance rate with IF method for the anti-dsDNA antibodies was 89.3% (25/28) and the con- cordance rates with DID for anti-Sm, anti-Sm/RNP, anti-SSA and anti-SSB antibodies were 85.7% (24/28), 82.1% (23/28), 92.9% (26/28) and 82.1% (23/28), respectively. In 16 discordant settings, thirteen (81.3%) were negative on DID and positive on EL-ANA/6 profiles. CONCLUSIONS: The results of the EL-ANA/6 profiles show good concordance rates with If and DID. EL-ANA/6 profiles showing quantitative profiles for multiple autoantibodies is useful for diagnosis and tool)ow-up of autoimmune disorders.
Antibodies ; Antibodies, Antinuclear* ; Autoantibodies ; Bile ; Blood Donors ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunodiffusion ; Prognosis ; Sensitivity and Specificity

No abstract available.
Hemangioma* ; Injections, Intralesional* ; Propranolol ; Triamcinolone*

Our study was performed to evaluate the efficacy of anthralin-UVB therapy for psoriasis by simplifying the conventional Ingram regimen, 34 patients(21 admitted, and 13 OPD patients) were included in our study and the resulti can be summarized as follows. 1. There were no cases of treatment failure. 16 patients(76. 2%) out of the 2l admitted patients and 7 patients(53.8%) out of the 13 OPD patients showed clearing. 2. In the case of the admitted patients, the mean numbers of therapy(days) of the improved patients reaching grade 4 were 12. 0(18. 1 days) in the trunk lesions and 15. 5 (22. 0 days) in the extremity lesions' and those of the cleared patients reaching grade 4 were 11. 2(16. 0 days) in the trunk lesions, and 13. 4(lg. 5 days) in the extremity lesions, but the difference was not significant statistically(pp o.ps). The difference between the therapeutic effects of the admitted and the OPD patients was significant statistically(p<0. 05). 3. There were some notable side effects such as staining, pruritus, and erythema, but there were no cases of therapy termination.
Erythema ; Extremities ; Humans ; Pruritus ; Psoriasis* ; Treatment Failure

We performed anthralin comparative study(0.01% vs 0.1%) to assess the effectiveness of low-strengh anthralin therapy in 34 psoriatic patients and the resu1ts can be summarized as follows. 1. In the case of 13 patients using Burdick UVB larnp, in 1 patient the effect of 0.1% anthralin was superior to that of 0.01% anthralin from the start to the end of treatment, in 5 patients(38.5%) initially the effect of 0.1% anthralin was superior but in time became equal to that of 0.01% anthralin, and in 7 patients (53.8%) the effect of either side was same throughout the courae of the treatment. In the case of 21 patients using Waldmann UVB cabinet, there were 2(9.5 %), 3(14.3%) and 16 patients(76.2%) in the order named above. 2. The side effect of 0.1% anthralin was more severe than or at least the same as that of 0.01% anthralin in every patient who complained about side effects. So low-strengh anthalin-UVB phototherapy was thought to be the effective and alternative method of treatment particularly for the purpose of lessening the side effects.
Anthralin* ; Humans ; Phototherapy ; Psoriasis*

OBJECTIVE: We investigated the effect of preeclampsia, birth weight, fetal sex, maternal body mass index(BMI) on cord blood leptin concentrations. This study is to test whether leptin would be increased in preeclampsia and to test cord leptin concentrations for correlation with maternal leptin concentrations. METHOD: Maternal blood samples were obtained from 56 normal pregnancies and 24 preeclampsia women prior to delivery. Umbilical cord blood were obtained from the all cases studied immediately after delivery. The total leptin levels were determined by radioimmunoassay. RESULTS: Mean maternal leptin level was 16.4+/-6.4ng/ml in normal pregnancy and was 19.4+/-7.9 ng/ml in preeclampsia. Mean cord leptin level was 5.4+/- 3.4ng/ml in normal pregnancy and 4.6+/-3.2ng/ml in preecalmpsia. Mean cord blood leptin level in female fetus was 6.6+/-3.7ng/ml and 4.8+/-2.8ng/ml in male fetus. CONCLUSION: This study shows that there are correlation with leptin level and fetal birth weight, body mass index, and fetal gender. Furthermore, physiologic role and mechanism of leptin of maternal serum and umbilical cord would be studied.
Birth Weight ; Body Mass Index ; Female ; Fetal Blood ; Fetus ; Humans ; Leptin* ; Male ; Plasma* ; Pre-Eclampsia ; Pregnancy* ; Radioimmunoassay ; Umbilical Cord*

Our study was performed to evaluate the efficacy of anthralin-UVB therapy on patients with psoriasis. We studied twenty two patients suffering from plaque-type psoriasis of varying degrees of severity. The results can be summarized as follows. l. 2p patients(90.9%) out of the total 22 patients showed grade 4 improvement. The rernaining 2 patients failed to respond to treatment, 2. Arnong the improved 2Q patients, 2 patients who were treated more than 3p times for grade 4 improvement were excluded, so cleared patients were 18(81.8%). 3. Arnong the 18 cleared patients, the mean nurnber of therapy wasg. 6 for grade 3 and 12. 5 for grade 4 in the cases of trunk lesiona, and 13. 2 for grade 3 and 17. 8 for grade 4 in the cases of extrernities lesions. With above results, anth-ralin-UVB therapy was rnore effective in lesions of the trunk than in those of extremi.ties. 4. Notable side effects were pruritus in 6 patients(27.3pg), staining in 4 patients (18,2%), and 1ITltatioB in 2 patients(9.1%)
Anthralin* ; Humans ; Phototherapy* ; Pruritus ; Psoriasis*

PURPOSE: It is agreed that tumor stage is the definitive prognostic indicator for patients with renal cell carcinoma. We investigated pathologic grade and cell subtype as another prognostic in each tumor stage. MATERIALS AND METHODS: We reviewed the medical records of 206 patients who underwent partial or radical nephrectomy for renal cell carcinoma between January 1991 and June 1998. Renal cell carcinoma grade, stage and cell subtype (conventional [clear cell], papillary, chromophobe, sarcomatoid type) were evaluated using the 1997 Union International Contre Ie cancer (UICC) and the American Joint Committee on Cancer (AJCC) grading, TNM staging criteria and renal cell carcinoma classification. Kaplan -Meier survival curves were used to determine 5-year survival for all patient groups. Univariate analysis using log rank test was performed to evaluate the prognostic significance of TNM stage, Fuhrman nuclear grade, cell subtype and tumor size. We investigated pathologic grade and cell subtype with log rank teat whether those were another significant prognostic factors in each tumor stage. Multivariate analysis was performed to determine which factors had an independent impact on survival of patients with renal cell carcinoma. RESULTS: Univariate analysis revealed that TNM stage (p<0.001), pathologic grad (p<0.001) were the important prognostic indicators for renal cell carcinoma. Survival was affected significantly by tumor size when cutoff diameter for localized T1 lesions was 7cm but not 2.5cm. Pathologic grade had a significant impact on patient survival (p<0.0001). In the cell subtype chromophobe type had the best survival and sarcomatoid type had the worst survival though cell subtype did not appear to affect survival significantly (p=0.0583). Multivariate analysis revealed that N classification (p=0.009) and M classification (p=0.018) were the most important prognostic indicators for cell subtype (p=0.841) were not shown to have any independent impact on patient survival. In the group of localized disease(TXN0M0 stage) at the diagnosis, cell subtype had a significant impact on survival in T1(p<0.001), T2(p=0.01) and T3(p=0.029) and grade in T1(p=0.0016) and T3(p=0.0054). CONCLUSIONS: Pathologic grade and cell subtype were significant predictors of survival in each T stage of localized disease though they didn't have independent impact on the patient survival.
Carcinoma, Renal Cell* ; Classification* ; Diagnosis ; Humans ; Joints ; Medical Records ; Multivariate Analysis ; Neoplasm Staging ; Nephrectomy