Tumoral form of pseudoangiomatous stromal hyperplasia (PASH) of male breast is a rare disease entity. We report on a case of PASH that presented as a palpable subareolar breast mass in a 46-year-old male who has been on hemodialysis due to chronic renal failure. To the best of our knowledge, no case of PASH in a male with chronic renal failure has yet been reported. We describe its mammographic and sonographic findings with correlative histopathologic features, confirmed by surgical excision.
Angiomatosis ; Breast ; Breast Diseases ; Humans ; Hyperplasia ; Kidney Failure, Chronic ; Male ; Rare Diseases ; Renal Dialysis

Mixed ductal-endocrine carcinoma of the pancreas is composed of ductal and endocrine carcinoma components and each component makes up a significant proportion in the primary tumor as well as in the tumor of metastatic sites. Mixed ductal-endocrine pancreatic carcinoma is exceptionally rare and, to our knowledge, only five cases have been reported in the literature. Recently we experienced a case of mixed ductal-endocrine pancreatic carcinoma with regional lymph node and hepatic metastases in a 63-year-old woman. Here, we report a case of mixed ductal-endocrine pancreatic carcinoma with a review of the literature.
Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Pancreas*

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. METHODS: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male: female 20: 7; age 47.6+/-12.9 years old; age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. RESULTS: Mean total sleep time on polysomnography was 401.4+/-57.8 min (range of 274.0 to 514.1 min). Mean RDI was 21.7+/-20.4 /hour. Mean FI was 21.9+/-13.0 / hour. RDI and FI showed significant correlation (r=0.55, p< 0.01). CONCLUSIONS: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.
Accident Proneness ; Actigraphy* ; Female ; Follow-Up Studies ; Humans ; Inpatients ; Outpatients ; Polysomnography ; Prevalence ; Seoul ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Deprivation ; Sleep Wake Disorders ; Wrist

OBJECTIVES: We attempted to compare the performance of 2 commercially available actigraphies with focus on sleep parameters, using polysomnography as standard comparison tool. METHODS: Fourteen normal volunteers (5 males and 9 females, mean age of 28+/-4.6 years) participated in this study. All the participants went through one night of polysomnography, simultaneously wearing 2 different kinds of actigraphies on each wrist. Polysomnographic and actigraphic data were stored, downloaded, and processed according to standard protocols and then statistically compared. RESULTS: Both ActiWatch (r) and SleepWatch (r) tended to overestimate the total sleep time, compared to the polysomnography. Sleep-Watch (r) tended to underestimate the sleep latency. The two actigraphs and the polysomnograph did not show significant difference of sleep efficiency, when compared with one another. In addition, all of the sleep parameters from the instruments showed linear correlations except in SleepWatch (r) 's sleep latency. The sleep parameters from the two actigraphs did not show much noteworthy difference, and linear relationships were found between the sleep parameters from the two actigraphs. There was no significant distinction in the results of the two different actigraphs. CONCLUSION: The results of two actigraphies can be used interchangeably since the sleep parameters of the two different actigraphies do not show significant differences statistically. Overall, it is not legitimate to use actigraphy as a substitute for polysomnography. However, since sleep parameters except sleep latency show linear correlations, actigraphy might possibly be used to follow up patients after polysomnography.
Actigraphy ; Female ; Healthy Volunteers ; Humans ; Male ; Polysomnography* ; Wrist

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell(WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRS (leukoreduction system) and COBE Spectra with PALL PXL 8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit(APU) in St. Mary s hospital were prospectively randomized into COBE Spectra LRS and COBE Spectra followed by PALL PXL 8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6+ 1.0 x 10 ' with COBE spectra LRS compared to 2.9+ 1.1 X 10 with COBE Spectra(p=0.002), and the mean WBC content per unit with COBE spectra LRS was 4.1 x 104(0.4-23.5) compared to 3.7 x 104(0.43-17.9) with PALL PXL""8(p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRS has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXL 8. Therefore, this data suggests that COBE Spectra LRS is conveient than COBE Spectra with PALL PXL 8 in clinical practice. (Korean J Blood Transfusion 10(1): 43-51, 1999)
Blood Component Removal ; Blood Group Incompatibility ; Blood Platelets* ; Blood Transfusion ; Cytomegalovirus Infections ; Humans ; Leukocytes* ; Prospective Studies ; Tissue Donors*

Plasmablastic lymphoma(PBL) is a recently described aggressive B-cell neoplasm, which usually manifests as a localized disease of the oral mucosa in individuals infected with human immunodeficiency virus(HIV). Recently, we encountered a case of plasmablastic lymphoma manifesting in the left maxillary sinus and cervical lymph node of a previously healthy HIV-negative man, 48 years of age. we conducted a fine-needle aspiration smear of the cervical lymph node, and this was found to be highly cellular with numerous large cells exhibiting eccentrically positioned nuclei, prominent nucleoli, and moderate quantities of basophilic cytoplasm. A biopsy of the mass in the maxillary sinus evidenced diffuse growth of similar plasmablastic cells. These tumor cells were negative for the leukocyte common antigens, CD20, CD3, CD30, and EMA. However, the cells tested positive for CD79a and CD138/syndecan-1. The tumor cells also exhibited L-light-chain restriction. The Ki-67 proliferation index was measured at almost 100%. The patient was diagnosed with plasmablastic lymphoma. After three cycles of combination chemotherapy and radiotherapy, the patient went into complete remission, and currently remains in this state.
Antigens, CD45 ; B-Lymphocytes ; Basophils ; Biopsy ; Biopsy, Fine-Needle* ; Cytoplasm ; Drug Therapy, Combination ; HIV ; Humans* ; Lymph Nodes ; Lymphoma* ; Maxillary Sinus ; Mouth Mucosa ; Radiotherapy

Gastric lipoma is rare submucosal tumor, accounting for less than 3% of all be- nign gastric tumor. Most are usually asymptomatic, but on occasion, they may present with abdominal pain, obstruction, dyspepsia, intussuception and gastrointestinal bleeding. Surgical resection is definitive diagnostic and therapeutic procedure. Surgical removal of gastric lipoma should be considered in the following situations: 1) the lesion is large, 2) the lesion is difficult to differentiate from malignant tumor, 3) the patient is symptomatic or has recurrent bleeding or obstruction. We report a case of gastric lipoma with bleeding in a 67-year-old male. Gastroscopy showed active gastric ulcer with fresh blood clot. Although medical conservative treatment was done, bleeding was continued. We referred patient to general surgical department for open surgical procedure and subtotal gastrectomy was performed. Histopathological examination of surgical gastric segment showed 5 5.5 cm sized ulcerated mass. Microscopic finding of cross section showed uniform and mature adipose cell, finding consistent with lipoma. We confirmed it submucosal gastric lipoma with ulcer bleeding.
Abdominal Pain ; Adipocytes ; Aged ; Dyspepsia ; Gastrectomy ; Gastroscopy ; Hemorrhage* ; Humans ; Lipoma* ; Male ; Stomach ; Stomach Ulcer ; Ulcer