A patient who had been admitted to the B.N.U.H. with coma and respiratory arrest from possible acute alcohol intoxication, has been treated with intensive care and discharged without any complication. It should be emphasized that a patient with respiratory arrest even due to unknown etiology must have continued intensive care, without giving up the patient.
Coma ; Humans ; Critical Care ; Resuscitation*

A patient who had been admitted to the B.N.U.H. with coma and respiratory arrest from possible acute alcohol intoxication, has been treated with intensive care and discharged without any complication. It should be emphasized that a patient with respiratory arrest even due to unknown etiology must have continued intensive care, without giving up the patient.
Coma ; Humans ; Critical Care ; Resuscitation*

Two cases of abnormalities of the left ventricular wall(left ventricular aneurysm or diverticulum) are presented. A saccular deformity of the left ventricle may be and aneurysm or a diverticulum. In one case, the defect seems to be subcalvular aneurysm(or fibrous diverticulum) or aneurysm of the membranous ventricular septum; this lesion seems to be a natural consequence of spontaneous closure of a defect of the membranous septum. The other case, it seems that the defect is ventricular aneurysm with syndrome of myocardial infarction and normal coronary arteries, or double or accessory chambered left ventricle. The thromboembolic phenomenon was noted on a left frontoparietal lobe of brain. Both cases have the diagnosis supported by cardiac catheterization and angiography. The clinical, angiographic and pathologic characteristic of diverticulum and aneurysm of the heart are reviewed, and an attempt is made to clarify the concept of aneurysm and diverticulum of the heart.
Aneurysm* ; Angiography ; Brain ; Cardiac Catheterization ; Cardiac Catheters ; Congenital Abnormalities ; Coronary Vessels ; Diagnosis ; Diverticulum* ; Heart ; Heart Ventricles* ; Myocardial Infarction ; Ventricular Septum

Forth-nine patients with clinically nonfunctioning pituitary adenomas were evaluated clinically, endocrinologically and morphologically in this study.The results obtained were as follows.1) The mean age was 47.1 years(range 23 to 76 years), and 22 were male(44.9%) and 27(55.1%) female.2) The major clinical manifestations of male patients were visual disturbance(72.7%), headache(54.5%), loss of libido(45.5%), but those of female visual disturbance(59.6%), headache(48.1%), amenorrhea(48.1%), loss of body hair(25.9%), and galactorrhea(22.2%).3) All were macroadenomas evaluated by CT scan, and in the male patients 16(72.7%) were grade III and 6(27.3%) grade IV by Hardy classification, and in the female patients 6(22.2%) were grade II, 12(44.4%) grade III, and 9(33.3%) grade IV.4) The elevation of serum prolactin were observed 7(31.8%) out of male, and 24(88.9%) of female.5) Combined stimulation test revealed that GH insufficiency was 89.6%, ACTH 58.9%, LH 58.7%, FSH 51.1 %, and TSH 50.0% and hormone insufficiency more than 4 pituitary hormone was 54.2%.6) Prolactin response to TRH decreased in 12(70.6%) of 17 patients with normal basal prolactin, and 19(76.0%) of 25 with elevated prolactin.7) Immunohistochemistry revealed that null cell adenoma was 57.1%, gonadotrope adenoma 26.5%, plurihormonal adenoma 8.0%, silent corticotrope adenoma 4.0%, thyrotrope adenoma(2.0%), and lactotrope adenoma(2.0%).8) The ultrastructural characteristics examined by electron-microscopy were similar despite of immunohistochemical differences.In summary, the prevalance of clinically nonfunctioning pituitary adenoma was middle aged men and women, and their main symptoms were visual disturbance and headache. Hyperprolactinemia and pituitary hormone insufficiency more than 4 hormone were observed commonly. Most of them were null cell adenoma and gonadotrope adenoma examined by immunohistochemistry. Further study using modern techniques: cell culture, subunit-immunostaining. And Northern blot analysis of mRNA for pituitary hormone or subunit, will be needed to clarify null cell adenomas.
Adenoma ; Adrenocorticotropic Hormone ; Blotting, Northern ; Cell Culture Techniques ; Classification ; Female ; Headache ; Humans ; Hyperprolactinemia ; Immunohistochemistry ; Lymphocytes, Null ; Male ; Middle Aged ; Pituitary Neoplasms ; Prolactin ; RNA, Messenger ; Tomography, X-Ray Computed

BACKGROUND: The detection of micrometastatic cells in patients with breast cancer may aid in determining of prognosis and in developing new therapeutic approaches. In this study, we evaluate an assay to identify breast cancer cells in the bone marrow of patients with breast cancer by using reverse-transcriptase polymerase chain reaction (RT-PCR) assay for cytokeratin 19 (CK-19) transcripts. METHODS: A CK-19 specific-nested RT-PCR assay was developed and optimized by using limited dilutions of an MCF-7 breast-cancer cell line mixed with normal bone-marrow specimens. The optimized assay was then used to examine bone-marrow samples obtained from 60 patients with breast cancer. The specificity was assessed by examining 20 negative controls using malignant hematologic disease. RESULTS: In the sensitivity calibration system, CK-19 expressing tumor cells were detected in the mixture of 10 MCF-7 cells in 107 normal bone-marrow cells. All 20 neagtive control samples failed to amplify. Bone marrow samples from 10 of 60 patients (16.7%) with breast cancer scored positive, indicating micrometastasis of the bone marrow. Seven of the 37 samples from patients whose axillary lymph nodes were negative based on conventional histopathological studies were positive when the CK-19 RT-PCR method was used. CONCLUSION: RT-PCR for CK-19 is a sensitive, specific, and rapid method for detecting micrometastatic mammary carcinoma cells in the bone marrow of patients with breast cancer. It could be helpful in diagnosing and monitoring metastastic breast cancer and detecting of micrometastasis. This method should be evaluated using a larger number of patients for long-term follow-up.
Bone Marrow* ; Breast Neoplasms* ; Breast* ; Calibration ; Cell Line ; Hematologic Diseases ; Humans ; Keratin-19 ; Keratins ; Lymph Nodes ; MCF-7 Cells ; Neoplasm Micrometastasis* ; Polymerase Chain Reaction ; Prognosis ; Sensitivity and Specificity

There is a growing interest in the factors related to insufficiency fractures. We are going to report three insufficiency fracture cases which are considered to be caused by osteoporosis, rheumatoid arthritis, steroid use and femoral shaft bowing among the patients not taking bisphosphonate. All cases are caused by low energy trauma and among these cases, one patient is being presented with a prodromal symptom and another patient complains of both prodromal symptoms and bilateral lesions.
Arthritis, Rheumatoid ; Femur ; Fractures, Stress ; Humans ; Osteoporosis ; Prodromal Symptoms

Lymphoepithelioma-like carcinonma of the skin(LELCS) is a rare tumor with a microscopic resemblance to lymphoepitheliomatous tumors of the nasopharynx. Less than 100 examples of LELCS are having been reported since its initial description in 1988. Elderly patient are preferentially affected, and the skin of the head and neck is the principal location for this neoplasm. We report a 70 year-old male patient who had brownish colored, moderately firm nodule on the left malar area of the face. Histopathologically, the nodule showed features of LELCS and he was treated with excision and local flap coverage.
Aged ; Head ; Humans ; Male ; Nasopharynx ; Neck ; Skin*

The pseudolymphoma syndrome is characterized by a triad of fever, lymphadenopathy, and an erythematous rash. Although this syndrome has been well documented with phenytoin therapy, it is uncommon with carbamazepine. We report a case of the pseudolymphoma syndrome due to carbamazepine in a 27-year-old man who had a triad of clinical symptoms.
Adult ; Carbamazepine ; Exanthema ; Fever ; Humans ; Lymphatic Diseases ; Phenytoin ; Pseudolymphoma*

Apocrine gland carcinoma is a rare form of sweat gland neoplasm with a distinctive cytologic appearance. Their occurrence has been reported mainly in the axilla and breast area. The authors describe a 51-year-old man with an apocrine gland carcinoma in the right axilla area. Physical exam revealed a 2.0 X 2.5 cm sized strawberry-like mass and histologic sections showed multiple cribriform pattern tumor nodules throughout the dermis. The periodic acid-Schiffs(PAS) diastase stain revealed positively staining granules in the cytoplasm of the neoplastic cells and stains for lysozyme and GCDFP-15(Gross Cystic Disease Fluid Protein-15) were also positive.
Amylases ; Apocrine Glands* ; Axilla ; Breast ; Coloring Agents ; Cytoplasm ; Dermis ; Humans ; Middle Aged ; Muramidase ; Sweat Gland Neoplasms

Recently a distinct subtype of lymphoma was reported, the natural killer(NK)/T-cell lymphoma, which can involve the skin in a primary or secondary event. NK/T-cell lymphoma is characterized by the expression of the NK-cell antigen CD56. CD56+ lymphoma are further subdivided into nasal and non-nasal NK/T-cell lymphoma. We report a case of primary nasal NK/T-cell lymphoma with secondary cutaneous involvement.
Lymphoma* ; Skin