Ticlopidine, a widely used antiplatelet agent, has been rarely reported to cause thrombotic thrombocytopenic purpura (TTP). To the best of our knowledge, its occurrence has never before been reported in Korea. A 69 years old female patient suffered from an acute ischemic stroke. Ticlopidine 250mg bid was started and she followed an uneventful clin-ical course. The platelet count was normal on the 1st and the 12th day of ticlopidine administration. Around the 31st day, at home, she developed purpura, dyspnea and a stuporous mental status. Under the diagnosis of TTP, a plasma exchange was performed and her condition eventually returned to the baseline status. Ticlopidine induced TTP can developed abruptly despite close monitoring of platelet count, as illustrated by this case. Physicians prescribing ticlopi-dine should be aware of this potentially dangerous complication.
Aged ; Diagnosis ; Dyspnea ; Female ; Humans ; Korea ; Plasma Exchange ; Platelet Count ; Purpura ; Purpura, Thrombotic Thrombocytopenic* ; Stroke ; Stupor ; Ticlopidine*

This study was designed to answer the question; (1) How does the DNA ploidy pattern change in hepatocarcinogenesis? (2) How does the nuclear morphology change in hepatocarcinogenesis? Diethylnitrosamine(DEN) (16.5 mg per kg) was subcutaneously injected to female Sprague-Dawley rats(150~200g) by weekly interval for 30 weeks. DNA ploidy and parameters of nuclear morphology were measured by image analyser(IBAS 200, Kontron, FRG). The DNA ploidy pattern was divided into three basic patterns(diploid, polyploid, and aneuploid modes). In 8 cases of saline-injected control rats, the DNA histograms showed all polyploid pattern. Inhepatocyte nodules(hyperplastic nodules), DNA diploidy was the most frequent pattern, being followed by polyploid and aneuploid DNA patterns, contrast to hepatocelular carcinomas in which polyploid DNA pattern was most frequently noted being followed by diploid and aneuploid DNA pattern. Although the nuclei of hepatocytes in hepatocyte nodules and hepatocellular carcinomas were larger and more pleomorphic than those of normal hepatocytes, they were as same as those of normal hepatocytes in regard to nuclear hyperchromasia. DNA content, which was increased in hepatocarcinogenesis, was significantly related to the nuclear area.
Female ; Humans ; Carcinoma, Hepatocellular

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

No abstract available.
Adult* ; Hernia* ; Humans

Intravascular lymphomatosis (IL) is a variant of non-Hodgkin's lymphoma with an predilection for the CNS. Most cases are not diagnosed until postmortem. IL is characterized by neoplastic proliferation of lymphoid cells within the lumen of small veins and arteries with minimal involvement of the parenchyma. We experienced a 62-year-old woman who presented with seizure and fever associated with anemia, elevated LDH and beta 2-microglobulin without systemic involvement. This report illustrates the diagnostic challenge of this rare disorder with a grave prognosis. (J Korean Neurol Assoc 19(4):413~416, 2001)
Anemia ; Arteries ; beta 2-Microglobulin ; Central Nervous System* ; Female ; Fever ; Humans ; L-Lactate Dehydrogenase ; Lymphocytes ; Lymphoma, Non-Hodgkin ; Middle Aged ; Prognosis ; Seizures ; Veins

No abstract available.
Hernia, Diaphragmatic*

No abstract available.

OBJECTIVE: To determine the safety and efficacy of immune ablation followed by autologous hematopoietic stem cell transplantation (HSCT) in refractory systemic lupus erythematosus (SLE). METHODS: Three patients who had been refractory to steroid and one or more immunosuppressive drug were included. Peripheral blood stem cells were mobilized with cyclophosphamide (CTX, 3 g/m(2)), followed by granulocyte-colony stimulating factor (5mug/kg/day). T lymphocytes were depleted from the graft by selection of CD34 positive cells. Conditioning regimens composed of high dose CTX (total dose 200 mg/kg) and anti-thymocyte globulin (total dose 90 mg/kg) in 2 patients and BEAM (BCNU 300 mg/m(2), etoposide 200 mg/m(2), cytarabine 200 mg/m(2), melphalan 200 mg/m(2)) in 1 patient. Stored stem cells were reinfused 48 hours after conditioning. RESULTS: Among 3 patients, first patient had lupus nephritis, second patient had overlap syndrome combined with rheumatoid arthritis (rhupus) and the last patient had severe thromobocytopenia and intractable polyserositis. No life threatening complications were observed during the treatment. All patients demonstrated rapid and marked improvement in organ function and quality of life just after HSCT. Previous massive proteinuria in first patient was decreased to less than 500 mg/day with 6 months follow up. Rhupus patient satisfied American college of rheumatology 70% response criteria with 3 months follow up. But third patient improved polyserositis dramatically 1 month after HSCT and relapsed at 9 weeks. CONCLUSION: In refractory SLE patients, HSCT can be performed safely with marked improvement and sustained withdrawal of all immunosuppressive medication. A further randomized trial is needed to confirm the efficacy and durability of remission.
Antilymphocyte Serum ; Arthritis, Rheumatoid ; Cyclophosphamide ; Cytarabine ; Etoposide ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Melphalan ; Proteinuria ; Quality of Life ; Rheumatology ; Stem Cells ; T-Lymphocytes ; Transplants

Shaken baby syndrome develop as a form of child abuse, with the majority of cases occurring during the first year of life. It results from extreme rotational cranial acceleration and deceleration effects induced by violent shaking of an infant. The characteristic injuries include subdural and subarachnoid hemorrhages, and retinal hemorrhages. We experienced three cases of shaken baby syndrome. Although the history of trauma was little known, all of these cases had subdural hemorrhages. We present the cases with a review of related literature.
Acceleration ; Child ; Child Abuse ; Deceleration ; Hematoma, Subdural ; Humans ; Infant ; Retinal Hemorrhage ; Shaken Baby Syndrome* ; Subarachnoid Hemorrhage

PURPOSE: The objective of this study was to evaluate the initial fixation strength of press-fit technique compared with titanium and biodegradable interference screws in ACL reconstruction using bone-patellar tendon-bone grafts. MATERIALS AND METHODS: Fifty porcine lower limbs were used. The graft in the press-fit group was harvested with a hollow oscillating saw to obtain a consistent and complete circular shape and that in the interference screw group was obtained with a conventional oscillating saw. With preload of 20 N, the specimens underwent 250 loading cycles between 0-2 mm of displacement. Thereafter, the specimens were loaded to failure after restoration of the preload. RESULTS: During the cyclic loading, none of press-fit or interference screw fixations failed and there was no significant difference in maximum loads between the groups. In groups of press-fit fixation with diameter of bone plug being larger that that of the femoral tunnel by 1.4 mm, the ultimate failure load was comparable with that of the titanium or biodegradable interference screw groups. The complete circular shape and increased diameter of the bone plug seemed to contribute the strong initial fixation. CONCOUSION: Press-fit fixation technique provides a secure and consistent fixation strength comparable with the metal or biodegradable interference screws.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Bone-Patellar Tendon-Bone Grafts ; Knee ; Lower Extremity* ; Titanium ; Transplants