PURPOSE: To determine the clinical and mammographic characteristics of primary lymphoma of the breast. MATERIALS AND METHODS: The clinical and mammographic records of five patients (six breasts; bilateral involvement in one patient) with histologically-proven lymphoma of the breast were retrospectively reviewed. RESULTS: All patients had complained of a palpable tender mass with relatively rapid growth over a period of about 3 months. In five cases, the mass was located in the right breast and in one case in the left. Mammography revealed diffuse increased opacity of the entire breast in three cases, a homogeneous well-defined mass in one, multiple well-defined masses in one, and ill-defined lobulated opacity in one. Skin thickening and architectural distortion was seen in one case, and axillary lymphadenopathy in two. In no case was microcalcification and nipple retraction seen. CONCLUSION: In primary breast lymphoma, mammographic finding are non-specific. When a breast grows rapidly and is tender, however, and mammography shows a relatively large well defined mass and associated axillary lymphadenoapathy, the possibility of primary lymphoma should be considered.
Breast* ; Humans ; Lymphatic Diseases ; Lymphoma* ; Mammography ; Nipples ; Retrospective Studies ; Skin

Common variable immunodeficiency(CVID) is a heterogeneous immunodeficiency syndrome characterized by hypogammaglobulinemia, recurrent bacterial infections, and a variety of immunological abnormalities. We report a 10-year-old boy diagnosed with CVID and a fatal case of measles. He was admitted for fever, cough, conjunctival injection with purulent discharge and maculopapular rash with some scattered pinpoint sized petechial lesions on the whole body for a duration of 5 days. Laboratory findings showed hypogammaglobulinemia [IgG 617 mg/dL(639-1,349 mg/dL), IgA 8.5 mg/dL(70-312 mg/dL), IgM 34.1 mg/dL(56-352 mg/dL)] and anti-measles antibody and anti HIV antibody were negative. He was treated with intravenous immunoglobulin 700 mg/kg on admission. Radiologic findings progressed from hyperaeration to fluffy margined interstitial and alveolar infiltrations on both lung fields. In spite of supportive and ventilator therapy, his pneumonia progressed to acute respiratory distress syndrome and he expired.
Agammaglobulinemia ; Bacterial Infections ; Child ; Common Variable Immunodeficiency* ; Cough ; Exanthema ; Fever ; HIV ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Immunoglobulins ; Lung ; Male ; Measles* ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Ventilators, Mechanical

PURPOSE: In this study, we aimed to review the clinical presentation of preterm infants with gastrointestinal perforations and compare the clinical features of gastric perforation with other intestinal perforations. METHODS: The medical records of preterm neonates with pneumoperitoneum, admitted to the neonatal intensive care unit (NICU) between January 1994 and December 2013, were retrospectively reviewed. RESULTS: Twenty-one preterm infants underwent exploratory laparotomy to investigate the cause of the pneumoperitoneum. The sample consisted of five patients (23.8%) with gastric perforation and 16 patients (76.2%) with intestinal perforation. No statistical differences were found in the birth history and other perinatal factors between the two groups. Underlying necrotizing enterocolitis, bilious vomiting, and paralytic ileus preceding the perforation were statistically more common in the intestinal perforation group. All preterm infants with gastric perforation survived to discharge; however, six preterm infants with intestinal perforation expired during treatment in the NICU. In the gastric perforation group, sudden pneumoperitoneum was the most common finding, and the mean age at diagnosis was 4.4+/-1.7 days of life. The location and size of the perforations varied, and simple closure or partial gastrectomy was performed. CONCLUSION: Patients with gastric perforation did not have a common clinical finding preceding the perforation diagnosis. Although mortality in previous studies was high, all patients survived to discharge in the present study. When a preterm infant aged less than one week presents with sudden abdominal distension and pneumoperitoneum, gastric perforation should first be excluded. Prompt exploratory laparotomy will increase the survival rates of these infants.
Diagnosis ; Enterocolitis, Necrotizing ; Gastrectomy ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Intestinal Perforation ; Intestinal Pseudo-Obstruction ; Laparotomy ; Medical Records ; Mortality ; Pneumoperitoneum ; Reproductive History ; Retrospective Studies ; Stomach Rupture ; Survival Rate ; Vomiting

OBJECTIVE: Psychosocial dysfunction was a nettlesome problem of schizophrenia even in their prodromal phase as well as in their first-episode. In addition, its relations with psychopathology were not determined. The aim of the present study was to examine whether the social and role function impairment was found in ultra-high risk for psychosis (UHR) individuals as well as first-episode schizophrenia patients and to explore its relations with psychopathology. METHODS: Thirty-seven normal controls, 63 UHR participants and 28 young, first-episode schizophrenia patients were recruited. Psychosocial functioning was examined by using Global function: Social and Role scale. Psychopathologies of positive, negative and depressive symptom were also measured. RESULTS: Social and role functioning in UHR were compromised at the equivalent level of those of first-episode schizophrenia patients. Multiple linear regression analysis revealed that social and role dysfunction was associated with negative symptoms in each UHR and first-episode schizophrenia group. CONCLUSION: These findings suggest that the significant impairment of social and role function may be appeared before the active psychosis onset at the level of extent to those of first-episode schizophrenia patients. The psychosocial intervention strategy especially targeting the negative symptoms should be developed and provided to individuals from their prepsychotic stage of schizophrenia.
Depression ; Humans ; Linear Models ; Psychopathology ; Psychotic Disorders* ; Schizophrenia*

PURPOSE: Under the proper program, day-case laparoscopic cholecystectomy is feasible in the aspect of postoperative recovery consisting of patient's satisfaction and postoperative complication. In this study, we plan a new protocol for laparoscopic cholecystectomy by analyzing factors that can reduce hospital days. METHODS: A total of 175 patients who underwent three-day laparoscopic cholecystectomy were initially selected. Out of 175 patients, secondary selection was executed using inclusion criteria. The selected patients were scheduled for new two-day laparoscopic cholecystectomy, and 89 patients were included in the data analysis. This study elucidated the comparative analysis between the discharged in the postoperative day 0 group and the postoperative day 1 group. RESULTS: The clinical characteristics were not significantly different between discharged in the postoperative day 0 group and the postoperative day 1 group. The combined diseases were not significantly different between the two groups. Post-operative complications in both groups were analyzed on the seventh day after the operation. No significant difference was observed between the two groups. Members of the patient group who were discharged on postoperative day 0 were given a survey regarding post-operative pain, desirability of discharge, and the level of satisfaction with patient education. The average score was 8.3 out of 10 points. In comparison of the total hospital cost between the two groups, the group discharged on postoperative day 0 had lower cost in all factors. CONCLUSION: We conclude that day-case laparoscopic cholecystectomy is as safe and effective as routine clinical pathway applied laparoscopic cholecystectomy in stable cardiovascular disease, uncomplicated pulmonary disease, and controlled DM patients.
Cardiovascular Diseases ; Cholecystectomy, Laparoscopic* ; Critical Pathways ; Hospital Costs ; Humans ; Lung Diseases ; Patient Education as Topic ; Postoperative Complications ; Statistics as Topic

No abstract available.

Recent genomewide association studies of large samples have identified genes that are associated with blood pressure. The Global Blood Pressure Genetics (Global BPgen) and Cohorts for Heart and Aging Research in Genome Epidemiology (CHARGE) consortiums identified 14 loci that govern blood pressure on a genomewide significance level, one of which is CASZ1 confirmed in both Europeans and Asians. CASZ1 is a zinc finger transcription factor that controls apoptosis and cell fate and suppresses neuroblastoma tumor growth by reprogramming gene expression, like a tumor suppressor. To validate the function of CASZ1 in blood pressure, we decreased Casz1 mRNA levels in mice by siRNA. Casz1 siRNA reduced mRNA levels by 59% in a mouse cell line. A polyethylenimine-mixed siRNA complex was injected into mouse tail veins, reducing Casz1 mRNA expression to 45% in the kidney. However, blood pressure in the treated mice was unaffected, despite a 55% reduction in Casz1 mRNA levels in the kidney on multiple siRNA injections daily. Even though Casz1 siRNA-treated mice did not experience any significant change in blood pressure, our study demonstrates the value of in vivo siRNA injection in analyzing the function of candidate genes identified by genomewide association studies.
Aging ; Animals ; Apoptosis ; Asian Continental Ancestry Group ; Blood Pressure ; Cell Line ; Cohort Studies ; Gene Expression ; Genome ; Heart ; Humans ; Kidney ; Mice ; Neuroblastoma ; RNA, Messenger ; RNA, Small Interfering ; Transcription Factors ; Veins ; Zinc Fingers

Neointimal hyperplasia causes vascular stenosis and subsequent thrombosis, which result in vascular access failure in patients undergoing hemodialysis. Interleukin-10 (IL-10) and tumour necrosis factor-alpha (TNF-alpha) are involved in this inflammatory process. The aim of this study was to investigate the relationship between vascular access failure and various inflammatory markers including the genetic polymorphisms of IL-10 and TNF-alpha. Seventy-five patients on hemodialysis with an arteriovenous fistula in place or an artificial graft (18 with vascular access failure and 82 without failure) and 98 healthy individuals were genotyped for IL-10 and TNF-alpha single nucleotide polymorphisms. Clinical and laboratory data including serum IL-10 and TNF-alpha levels were compared. Stimulated IL-10 levels, from in vitro incubation of blood with lipopolysaccharide, were also obtained and compared. Female gender, hypoproteinemia, and hypertriglyceridemia were associated with vascular access failure. The basal TNF-alpha level was significantly higher in patients with access failure. The distribution of IL-10 and TNF-alpha genotype did not differ among patients with or without access failure. This study could not demonstrate a relationship between genetic polymorphisms and vascular access failure. However, an altered immune response and inflammation might contribute to vascular access failure.
Adult ; Aged ; Arteriovenous Shunt, Surgical/*adverse effects ; Catheters, Indwelling/*adverse effects ; Cross-Sectional Studies ; Female ; Humans ; Interleukin-10/blood/*genetics ; Male ; Middle Aged ; *Polymorphism, Single Nucleotide ; *Renal Dialysis ; Tumor Necrosis Factor-alpha/blood/*genetics

PURPOSE: To evaluate the ultrasonographic features of nonlactiferous breast abscess. MATERIALS AND METHODS: We retrospectively reviewed ultrasonograms of 21 cases with surgically and clinically proved nonlactiferous breast abscess. The cases included 17 cases of acute or chronic inflammation and 4 cases of tuberculosis. RESULTS: Location of the lesion was subareolar in 15 cases and peripheral in 6. Mean anteroposterior/transverse diameter ratio was 0.49. Internal echogenicitiy of the lesion was variable, with heterogeneous mixed-echoic echotexture in 18 cases and homogeneous hypoechoic in 3. Margin of the lesion was irregular in 18 cases(85.7%) and posterior sonic enhancement was observed in 17 cases(81%). There were also noted obliteration of adjacent superficial fascia, localized skin thickening, and sinus tract or ductal ectasia in 19(90.5%), 9 (42.9%), and 9(42.9%) cases respectively. CONCLUSION: Major ultrasonographic findings of nonlactiferous breast abscess was subareolar located, variable shaped mass with posterior enhancement. Additional findings were fistular formation, loss of superficial fascia, and axillary lymphadenopathy.
Abscess* ; Breast* ; Dilatation, Pathologic ; Inflammation ; Lymphatic Diseases ; Retrospective Studies ; Skin ; Subcutaneous Tissue ; Tuberculosis ; Ultrasonography

PURPOSE: To evaluate the ultrasonographic features of nonlactiferous breast abscess. MATERIALS AND METHODS: We retrospectively reviewed ultrasonograms of 21 cases with surgically and clinically proved nonlactiferous breast abscess. The cases included 17 cases of acute or chronic inflammation and 4 cases of tuberculosis. RESULTS: Location of the lesion was subareolar in 15 cases and peripheral in 6. Mean anteroposterior/transverse diameter ratio was 0.49. Internal echogenicitiy of the lesion was variable, with heterogeneous mixed-echoic echotexture in 18 cases and homogeneous hypoechoic in 3. Margin of the lesion was irregular in 18 cases(85.7%) and posterior sonic enhancement was observed in 17 cases(81%). There were also noted obliteration of adjacent superficial fascia, localized skin thickening, and sinus tract or ductal ectasia in 19(90.5%), 9 (42.9%), and 9(42.9%) cases respectively. CONCLUSION: Major ultrasonographic findings of nonlactiferous breast abscess was subareolar located, variable shaped mass with posterior enhancement. Additional findings were fistular formation, loss of superficial fascia, and axillary lymphadenopathy.
Abscess* ; Breast* ; Dilatation, Pathologic ; Inflammation ; Lymphatic Diseases ; Retrospective Studies ; Skin ; Subcutaneous Tissue ; Tuberculosis ; Ultrasonography