To apply retinal capillary blood flow measurements using Scanning laser Doppler Flowmetry(SLDF) to clinical use, they should be reproducible and no interpersonal difference in nomal subject. Furthermore, the method of measurements must be simple, standardized and show acceptable range of error. We studied 10 eyes of 10 healthy normal subjects. Each subject was scanned in 2 sessions which were separated by at least 2 hours. In each session, we obtained 5 scans and measured macular capillary blood flow in two elected areas from the scanning images. The coefficients of variation of volume, flow, and velocity at each area were ranged from 3.4 to 13.2% 1.4 to 16.9%, and 3.1 to 14.3%, respectively, The reproducibility of measurements was good at each corresponding areas in each subject. No statistically significant locational difference was observed(Kolmogorov-Smirnov test, p>0.05). The Spearman rank correlation coefficients(r) were volume 0.75, flow 0.71, and velocity 0.73. They showed relatively significant correlation between first and second sessions. But there were signigicant differences on interpersonal difference in all 3 parameters: volume, flow, and velocity(Kruskal-Wallis one way ANOVA test. p<0.05). The comparison of measurements between different persons was not meaningful.
Capillaries* ; Humans ; Laser-Doppler Flowmetry* ; Retinaldehyde

To increase retinal blood flow, we attempted to increase blood flow of ophthalmic artery which in the major vascular supply to the eyeball. The authors evaluated changes in blood flow of ophthalmic artery and retinal capillary after compression of superficial temporal artery. In 5 normal healthy subjects, the superficial temporal artery was compressed for 10seconds and the blood flow was measured with color doppler imaging and Heidelberg Retinal Flowmeter(HRF). After compression, the mean volume of ophthalmic artery was increased by 59.3% and the mean change of diastolic velocity was significantly increased by 29.6%. Systolic velocity did not changing significantly. For evaluation of retinal microcirculation, we measured volume, flow, velocity in retina and optic nerve head. The relative ratio in changes of volume, flow, velocity were 87.9%, 91.5%, 92.6%, in retina respectively and 110.1%, 140.7%, 139.5%, respectively in optic nerve head. These significant changes were not statistically(P>0.05). In 5 diabetic patients with damaged autoregulatory mechanism, the relative ratio in changes of volume, flow, velocity were 114.25%, 118.30%, 117.6%, respectively. These changes were not statistically significant(P>0.05). Our results indicate that the increase of blood flow in ophthalmic artery by compressing superficial temporal artery did not increase retinal blood flow.
Capillaries ; Humans ; Microcirculation* ; Ophthalmic Artery ; Optic Disk ; Retina ; Retinaldehyde ; Temporal Arteries*

Sequential lymphoma is defined as two different types of lymphoma that occur in the same patient at different anatomic sites and times. In most cases, the two distinct histologies belong to the same lineage (B- or T-cell lymphoma), though cases with both have been observed. A few cases of Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphomas arising in patients with angioimmunoblastic T cell lymphoma (AITL) have been reported. Immune deficits inherent in AITL, combined with the immunosuppressive effects of the therapy, may have allowed unchecked EBV-induced proliferation of latently or newly EBV-infected B cells with eventual clonal selection and progression to aggressive B-cell lymphoma. Here, we report a case of AITL in which EBV-positive diffuse large B-cell lymphoma (DLBCL) arose 9 months after the initial diagnosis of AITL.
B-Lymphocytes ; Herpesvirus 4, Human ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; T-Lymphocytes

BACKGROUND/AIMS: Although diagnosis and surgical treatment for distal common bile duct cancer have enormously advanced, survival is not satisfactory and its prognostic factors are still being debated. Thus, we evaluated the outcomes and prognostic factors after major resection for distal extrahepatic cholangiocarcinoma (dCC). METHODS: One hundred and fifty-four patients who underwent major resection such as pancreaticoduodenectomy for dCC were retrospectively analyzed. We investigated clinical features, postoperative complications, survival, and prognostic factors of dCC. CONCLUSIONS: One hundred and three (66.9%) male and 51 (33.1%) female patients were enrolled and their mean age was 59.6 (31-78) years. Among them, 97 patients (63.0%) underwent Whipple's procedure, 45 (29.2%) pylorus-preserving pancreaticoduodenectomy, 7 (4.5%) total pancreatectomy, and 5 (3.3%) hepatopancreaticoduodenectomy, respectively. Mean follow-up duration was 26.6 (0.4-108.5) months. The postoperative morbidity and mortality were 42.2% and 1.3%, respectively. Five-year survival rate was 32.8% and mean survival duration was 47.2 (39.1-55.3) months. Type of biliary drainage (percutaneous transhepatic biliary drainage), lymph node status (positive), and cellular differentiation (moderate or poor) were significant indicators for death in multivariate analysis of resectable dCC. CONCLUSIONS: Moderate or poor cellular differentiation and lymph node metastasis may be independent poor prognostic factors for resectable dCC.
Adult ; Aged ; Bile Duct Neoplasms/mortality/*surgery ; *Bile Ducts, Extrahepatic ; Biliary Tract Surgical Procedures ; Cholangiocarcinoma/mortality/*surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Risk Factors ; Survival Rate

BACKGROUND: The p16 protein is a cyclin-dependent kinase inhibitor (CDKI) that inhibits cell cycle progression from phase G1 to phase S in the cell cycle. Many p16 gene mutations have been noted in many cancer-cell lines and in some primary cancers. These mutated genes caused abnormal or aberrant expression of the p16 protein, which might have contributed to the malignant progression of the cells by deranging the cell cycle. This study was to examine the abnormal or aberrant expression of the p16 protein in breast cancer tissue by using p16 protein specific immunohistochemical staining. METHODS: p16-protein-specific immunohistochemical staining was performed on 31 breast-cancer tissue samples. Twenty-four cases among the 31 tissue staining slides simultaneously showed a normal breast-tissue portion on the same staining slide. Microscopic photographs of both the breast-cancer and the normal- tissue portion were taken at the same magnification to compare the statistically analyzed fraction of red or brown colored p16 stained nuclei. RESULTS: In the breast cancer tissue, 7 (22.6%) showed totally negative, with less than 5% of the nuclei staining. The completely negative cases were not related to the stage of the disease (p=0.096) or to the histopathologic grade (p=0.20). The staining ratios of the breast-cancer tissue and the normal tissue were 26.2 ( +/- 18.7)% and 72.4 ( +/- 18.8)%, respectively. In the breast-cancer tissue, the ratio of expression of the p16 protein was significantly lower than in the normal tissue (p=0.001). CONCLUSIONS: In the carcinogenesis of some breast cancers, low expression of the p16 protein may play an important role in the unlimited proliferation of tumor cell due to a loss of the cell-cycle-regulating role of the p16 protein.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cyclin-Dependent Kinase Inhibitor p16* ; Genes, p16 ; Humans* ; Phosphotransferases

PURPOSE: To compare the enhancement patterns of 24-gadolinium-tetrazacyclodode-cane tetracetic acid (DOTA)-dendrimer (Gadomer-17) with those of gadopentetate dimeglumine (Magnevist) in postoperative scars in rabbits. MATERIALS AND METHODS: Twelve rabbit thighs with experimentally induced postoperative scars underwent dynamic contrast-enhanced MR imaging with both Gadomer-17 and gadopentetate dimeglumine at a 24-hr interval at one (n = 10), two (n = 8) and three months (n=4) after scar induction. The enhancement and the ratios of lesions at each time point, peak enhancement ratios, and the slope and shape of curves were assessed. RESULTS: At all time points, enhancement ratios were significantly lower after the injection of Gadomer-17 than with gadopentetate dimeglumine (p<0.05). Peak enhancement ratios were significantly lower with Gadomer-17 (1.29+/-0.15) than with gadopentetate dimeglumine (1.61+/-0.31) (p<0.01). The slope values were 2.99%/min+/-2.72 after Gadomer-17 injection and 8.99%/min+/-7.32 after gadopentetate dimeglumine injection (p<0.01). The enhancement ratio curves showed mostly the plateau pattern with Gadomer-17 (90.9%), while for gadopentetate dimeglumine, the curve pattern was either plateau (50%) or washout (50%). Difference in enhancement characteristics between the two contrast agents were most pronounced for one-month scars. CONCLUSION: With Gadomer-17, weaker enhancement and the plateau pattern were found in postoperative scars, whereas stronger enhancement and either washout or the plateau pattern were found with gadopentetate dimeglumine.
Animals ; Cicatrix* ; Contrast Media ; Gadolinium DTPA* ; Magnetic Resonance Imaging* ; Rabbits ; Thigh

Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. It is a part of a spectrum of disease in which lung tissue is devitalized(such as necrotizing pneumonia, pulmonary abscess), but apart from them, pulmonary gangrene has mo re extensive area of necrosis and thrombosis of large vessels plays a prominent role in the pathogenesis. We experienced a case of pulmonary gangrene in 71 year old female obstructive pneumonia patient with non-small cell lung carcinoma. She complained high fever, chill and despite treatment with antibiotics, pneumonia progressed to empyema. At that time chest radiograph showed a large cavity including sloughed lung tissue, freely moving to dependent position at both lateral decubitus view. RML and RLL were resected and compression of pulmonary vessels by enlarged lymph nodes was observed. Defervescence was obtained immediate postoperative period and the patient was discharged after infection control with antibiotics, chest tube drainage. The perivascular ly mph nodes dissected during lobectomy were proved to be reactive hyperplasias. We speculated that the carcinoma caused obstructive pneumonia, in turn, resulted in reactive hyperplasia of the draining lymph nodes surrounding the large vessels and finally the lung tissues supplied by them necrotized and sloughed.
Aged ; Anti-Bacterial Agents ; Chest Tubes ; Drainage ; Empyema ; Female ; Fever ; Gangrene* ; Humans ; Hyperplasia ; Infection Control ; Lung* ; Lymph Nodes ; Necrosis ; Pneumonia* ; Postoperative Period ; Radiography, Thoracic ; Thrombosis

Pulmonary gangrene is a rare complication of severe pulmonary infection in which a pulmonary segment or lobe is sloughed. It is a part of a spectrum of disease in which lung tissue is devitalized(such as necrotizing pneumonia, pulmonary abscess), but apart from them, pulmonary gangrene has mo re extensive area of necrosis and thrombosis of large vessels plays a prominent role in the pathogenesis. We experienced a case of pulmonary gangrene in 71 year old female obstructive pneumonia patient with non-small cell lung carcinoma. She complained high fever, chill and despite treatment with antibiotics, pneumonia progressed to empyema. At that time chest radiograph showed a large cavity including sloughed lung tissue, freely moving to dependent position at both lateral decubitus view. RML and RLL were resected and compression of pulmonary vessels by enlarged lymph nodes was observed. Defervescence was obtained immediate postoperative period and the patient was discharged after infection control with antibiotics, chest tube drainage. The perivascular ly mph nodes dissected during lobectomy were proved to be reactive hyperplasias. We speculated that the carcinoma caused obstructive pneumonia, in turn, resulted in reactive hyperplasia of the draining lymph nodes surrounding the large vessels and finally the lung tissues supplied by them necrotized and sloughed.
Aged ; Anti-Bacterial Agents ; Chest Tubes ; Drainage ; Empyema ; Female ; Fever ; Gangrene* ; Humans ; Hyperplasia ; Infection Control ; Lung* ; Lymph Nodes ; Necrosis ; Pneumonia* ; Postoperative Period ; Radiography, Thoracic ; Thrombosis

BACKGROUND: The t(12;21)(p13;q22), which fuses the TEL gene on chromosome 12p13 and the AML1 gene on chromosome 21q22, is observed in approximately 20~25% of childhood B-lineage acute lymphoblastic leukemia (ALL) cases and is associated with a favorable outcome. A retrospective study was conducted to investigate the frequency of TEL/AML1 fusion in the patients diagnosed as childhood B-precursor ALL. METHODS: Because of the low detection rate by routine karyotypic analysis, we studied 54 children with B-lineage ALL using the fluorescence in situ hybridization (FISH) analysis. RESULTS: Results of this analysis demonstrated a 9.3% frequency of TEL/AML1 fusion, relatively lower than Japanese, Taiwanese and Caucasian children. All five patients with TEL/AML1 fusion showed CD10 positivity and predominance of male patients (4:1). Two cases of TEL/AML1 positive groups expressed the myeloid antigens, but no significance was noted (P>0.05). In TEL/AML1 positive groups, the leukemia was developed between 4 and 5 years old age (favorable age) and showed low initial leukocyte counts (<50,000/micro L). CONCLUSION: Although these findings combined with earlier reports indicate that TEL/ AML1 fusion was frequent genetic abnormality in childhood ALL, relatively low frequency in Korean patients suggested the existence of geographic or racial variations in the genotype of ALL.
Asian Continental Ancestry Group ; Child ; Child, Preschool ; Fluorescence ; Genotype ; Humans ; In Situ Hybridization ; Leukemia ; Leukocyte Count ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Retrospective Studies

BACKGROUND: The myelodysplastic syndromes (MDS) in childhood is considered to be very rare and the nature of this disease in childhood is very different from that in adults. We analyzed the hematologic findings of childhood myelodysplastic syndrome. METHODS: The retrospective study was performed with the confirmed patients who were admitted to the Department of Pediatrics, Asan Medical Center (AMC) from June 1989 till May 1999, to analyze the hematologic findings. Sixteen children with a primary myelodysplastic syndrome (MDS) were presented to AMC during a 10 year period. RESULTS: Morphological assessment of the peripheral blood and the bone marrow showed nine patients (56%) had refractory anemia (RA), two patients (13%) had RA with excess blasts (RAEB), five patients (31%) had RAEB in transformation (RAEB-t). Five children with juvenile chronic myelogenous leukemia were diagnosed over the same period. Age distribution showed the predilection between 6~10 years and male : female ratio was 1 : 1. Inperipheralblood, pancytopenia was found in seven cases (44%) and leukocytosis in four cases (25%). The bone marrow findings showed hypercellularity in 54%, hypocellularity in 8% and variable cellularity in 15% and myelofibrosis was observed in 23%. Various dyspoietic changes of erythrocytes, leuko- cytes and platelets in peripheral blood and three cell lines in bone marrow were observed and trilineage dysplasia was observed in 62% of MDS, and 56% of RA. The four cases (25%) of RAEB and RAEB-t have transformed to acute myelogenous leukemia. CONCLUSION: In our study, the MDS in childhood seemed to be characterized by higher incidence of RA. Compared with the adult MDS, trilineage dysplasia in RA was frequently seen, but, no significant differences of dyspoietic features between adults and childhood were observed.
Adult ; Age Distribution ; Anemia, Refractory ; Anemia, Refractory, with Excess of Blasts ; Bone Marrow ; Cell Line ; Child ; Chungcheongnam-do ; Erythrocytes ; Female ; Humans ; Incidence ; Leukemia, Myeloid, Acute ; Leukemia, Myelomonocytic, Juvenile ; Leukocytosis ; Male ; Myelodysplastic Syndromes* ; Pancytopenia ; Pediatrics ; Primary Myelofibrosis ; Retrospective Studies