Soluble compounds of chromium are widely used in industrial processes, including printing, photography, pyrotechnics, dyeing, electroplating, aircraft, shipbuilding, and leather tanning. Exposure in industry is generally via the inhalation of dusts and fumes. Ingestion of chromium (chromate or dichromate salt) has occurred accidentally in suicide attempts and during drug experimentation and may causes ulceration of the bowel, diarrhea, hemorrhagic diathesis, acute renal failure, and hepatic damage. Ingestion of hexavalent chromium com-pounds is considered to be one hundred times more toxic than the trivalent compounds. Chromium poisoning in children is an uncommon, potentially lethal form of poisoning which could possibly increase in incidence because of the resumed greater domestic distribution of dichromate in Korea. We report a case of ammonium dichromate inges-tion by a child that resulted in a healthy discharge.
Acute Kidney Injury ; Aircraft ; Ammonium Compounds* ; Child ; Chromates ; Chromium ; Diarrhea ; Dust ; Eating ; Electroplating ; Hemorrhagic Disorders ; Humans ; Incidence ; Inhalation ; Korea ; Photography ; Poisoning* ; Suicide ; Tanning ; Triacetoneamine-N-Oxyl ; Ulcer

Primary segmental omental infarction in adults is very rare and occasionally occurs due to impaired perfusion to the greater omentum. Most authors believe that the condition results from an embryologic variant associated with anomalous and fragile blood supply of the right lower portion of the greater omentum, which is consequently susceptible to infarction. Since there are no characteristic clinical findings, the clinical presentation often mimics acute appendicitis or cholecystitis. However, in the proper clinical setting, the correct diagnosis can be established by the radiologist; therefore, unnecessary surgery can be avoided in many cases. Cross-sectional imaging by ultrasound or computed tomography will demonstrate characteristic findings in a location corresponding to the patient's point of maximal tenderness. These findings consist of an ovoid or cake-like mass in the omental fat with surrounding inflammatory changes. We report a case of primary segmental omental infarction in an adults who was treated conservatively after the diagnosis was established with clinical findings.
Abdominal Pain ; Adult ; Appendicitis ; Cholecystitis ; Diagnosis ; Humans ; Infarction* ; Omentum ; Perfusion ; Ultrasonography ; Unnecessary Procedures

In various autopsy series, overdiagnosis as well as underdiagnosis of pulmonary embolism has been reported. During the past decade, mortality rate has not declined despite advances in diagnostic methods. To evaluate the hypothesis that changes of hemodynamic parameters responded by mean pulmonary arterial pressure differences are of paramount importance to guide prognosis, experimental model of anesthetized dogs was used. Six dogs were anesthetized with 15 milligrams per kilogram of pentobarbital sodium, given intravenously and paralyzed with 2 milligrams of pancuronium bromide. 0.3 to 0.8 gram per kilogram of autologous blood clot was infused into the right atrium through a left external jugular vein. The dogs after embolization were divided into group A(mean pulmonary arterial pressure 33mmHg) and group B(mean pulmonary arterial pressure 43 mmHg). Each group of three dogs was monitored for a total of 4.5 hours. A 7F Swan-Ganz catheter was positioned and used to measure with fluid-filled transducer pulmonary capillary wedge pressure, mean pulmonary arterial pressure and mean right atrial pressure. Cardiac ouput was measured in triplicate by thermodilution and divided by weight to obtain the cardiac index. Blood gases, pH and saturation of arterial blood were measured. White blood cell and platerlets were counted in arterial blood. The results are as follows : 1) Changes in mean arterial pressure showed no significant differences between group A and group B following embolization. 2) Changes in mean pulmonary arterial pressure showed significant differences between group A and group B(p<0.05). 3) Changes in cardiac index showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 4) Changes in total pulmonary resistance showed significant differences between group A and group B after 45 minutes following embolization(p<0.05). 5) PaO2 showed significant differences between group A and group B after one hour following embolization(p<0.05), but arterial pH showed no significant difference. 6) Changes in mean pulmonary capillary wedge pressure, mean right atrial pressure and heart rates showed no significant differences between group A and group B following embolization. In conclusion, changes in mean pulmonary arterial pressure, cardiac index, total pulmonary resistance and PaO2 showed significant differences between group A and group B following embolization.
Animals ; Arterial Pressure ; Atrial Pressure ; Autopsy ; Catheters ; Dogs* ; Gases ; Heart Atria ; Heart Rate ; Hemodynamics ; Hydrogen-Ion Concentration ; Jugular Veins ; Leukocytes ; Models, Theoretical ; Mortality ; Pancuronium ; Pentobarbital ; Prognosis ; Pulmonary Artery* ; Pulmonary Embolism* ; Pulmonary Wedge Pressure ; Thermodilution ; Transducers

BACKGROUND/AIMS: The aim of this study was to determine whether the margin of early to be detected gastric cancer (EGC) and gastric adenoma is easier to be detected with autofluorescence imaging (AFI) than with white-light endoscopy (WLE). METHODS: A total of 102 lesions (48 EGCs and 54 gastric adenomas) found in 98 patients were removed endoscopically or surgically. The measured length of each pathology specimen was compared with the lengths estimated using WLE, AFI, and chromoendoscopy. RESULTS: The lesions could be discriminated from surrounding mucosa by AFI in 86 cases (84.3%). The detection rates were similar for elevated lesions (85.1%) and flat/depressed lesions (82.9%, p=0.770). In terms of histology, the detection rate was slightly higher for adenomas (90.7%) than for cancer (77.1%, p=0.058). The estimated length was shorter than the pathologic length in 31.4% of cases when using WLE and 22.1% of cases when using AFI (p=0.168). The resection range was larger for EMR than for AFI in 24 of 80 cases (30.0%). CONCLUSIONS: WLE tends to underestimate the size of EGCs, whereas AFI tends to overestimate their size.
Adenoma ; Endoscopy ; Fluorescence ; Humans ; Mucous Membrane ; Optical Imaging ; Prospective Studies ; Stomach Neoplasms

Hematopoietic stem cell transplantation (HSCT) recipients have a risk of post-transplant lymphoproliferative disorder (PTLD), which normally develops in Epstein-Barr virus (EBV) transformed donor B lymphocytes. The incidence of Hodgkin's lymphoma (HL) ranges from 1.8% to 3.4% of PTLD after HSCT. There are no case reports of early onset HL-like PTLD that developed less than one year after HSCT. We encountered a case of early onset PTLD after an unrelated HSCT following reduced-intensity conditioning with cyclophosphamide/fludarabine/thymoglobulin. A 24 year old patient with severe aplastic anemia developed multiple lymphadenopathies at day 95 after HSCT. The excisional biopsy revealed HL-like PTLD, which tested positive to immunohistochemical staining for the EBV. The Ann Arbor stage was IIA. Immunosuppressive agents were discontinued for 2 weeks in order to induce a graft-versus-lymphoma effect without a response. A total 4 cycles of chemotherapy with doxorubicin (adriamycin)/bleomycin/ vinblastine/dacarbazine (ABVD) and radiotherapy (total dosage 3,400 cGy) were then carried out. The response to salvage treatment was complete remission. The patient showed no evidence of the disease at the follow-up performed 32 months after HSCT.
Anemia, Aplastic ; B-Lymphocytes ; Biopsy ; Doxorubicin ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Herpesvirus 4, Human ; Hodgkin Disease ; Humans ; Immunosuppressive Agents ; Incidence ; Lymphoproliferative Disorders ; Tissue Donors

It is well known that developmental delay or arrest occurs before implantation in mamals, which have undergone in vitro culture. Recently, these phenomena are being attributed to oxygen free radicals, and successful cell culture are being obtained by lowering the oxygen environment of in vitro culture. This is due to the fact that the oxygen concentration in the fallopian tube is around 5%, which is lower than the room air 20% concentraition for in vitro culture. Superoxide dismutase(SOD), which are free radical scavenger, were added to early embryo mice culture and compared the free radical level at each stage of development with that of culture in which free radical scavenging agent was not added. The highest free radical level in control group observed in the late 2-cell stage and was markedly decreased if SOD added to culture media. Blastulation rate, hatching rate, and blastomere count as the parameters of embryo development was significantly increased in the experimental group. This study suggests the possibility of improvement in in-vitro embryo culture with media including free radical scavengers.
Animals ; Blastomeres ; Cell Culture Techniques ; Culture Media ; Embryonic Development ; Embryonic Structures* ; Fallopian Tubes ; Female ; Free Radical Scavengers ; Free Radicals ; Mice* ; Oxygen ; Pregnancy ; Superoxide Dismutase* ; Superoxides*

In this study we present a case of an angiocentric T-cell lymphoma (ACTL) which involve the esophagus. A 37-year-old male was admitted with dysphagia, odynophagia, and weight loss for 3 months. Two months before his admission, he had undergone on endoscopy with a biopsy. The first endoscopic findings revealed a large ulcerative lesion on the esophagus, although there had been no evidence of lymphoma upon microscopic examination. On the follow up endoscopic examination, this ulcerative lesion revealed progressive and destructive change. Histopathology of the third biopsied specimens showed large atypical lymphocyte infiltrates with angiocentric and angioinvasive features. Immunohistochemical studies revealed that the atypical (large) lymphocytes had T-cell phenotypes (CD3+, CD5+, and CD43+) and contained few reactive B-cells (CD20+), We assume that this is the first case of ACTL involving the esophagus and larynx.
Adult ; B-Lymphocytes ; Biopsy ; Deglutition Disorders ; Endoscopy ; Esophagus* ; Follow-Up Studies ; Humans ; Larynx ; Lymphocytes ; Lymphoma ; Lymphoma, T-Cell* ; Male ; Phenotype ; T-Lymphocytes* ; Ulcer ; Weight Loss

Adenocarcinoma is the most common type of malignant tumor arising in the stomach, accounting for approximately 95% of malignant gastric neoplasms. The majority of remainder is lymphoma. Although H. pylori infection has been implicated as a common cause of both adenocarcinoma and lymphoma of the stomach, synchronous occurrence of both tumors is very rare. We present a case of a 23- year-old-female who presented with epigastric discomfort and was found to have synchronous low-grade B-cell MALT lymphoma and adenocarcinoma of the stomach in association with H. pylori infection.
Adenocarcinoma ; B-Lymphocytes ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Stomach ; Stomach Neoplasms*

PURPOSE: Many authors have reported that obesity is a serious health problem in schoolage children and adolescents and recently obese children are increasing. Accurate diagnosis is needed to estimate the prevalence rate and trend of obesity. We studied body mass index(BMI) percentile for age and sex as a reliable and valid screening for adiposity. METHODS: We measured weight and height of 33,329 schoolage children to estimate obesity according to body mass index(weight in kilograms/height in meters2) and different standard weight. We also calculated BMI percentiles according to age and sex. We defined obesity for screening purposes as body mass index(BMI) equal to or in excess of the 95th percentile for age and sex. We also compared the prevalence of obesity according to a different standard weight. RESULTS: The mean value of body mass index(BMI) increases with age and tends to be slightly higher for male than female subjects. The 95th percentiles of body mass index(BMI) ranges from 18.9kg/m2 to 28.2kg/m2 for both males and females. No significant differences were apparent in the mean value of body mass index for each year. CONCLUSION: The percentile curves of body mass index(BMI) will help pediatricians to determine the relative ranking of patients compared with large sample of healthy schoolage children. Further studies are needed to define a useful criteria for defining obesity using body mass index(BMI) in childhood and adolescence. A longitudinal study and nationwide sampling will be required to overcome the limitation of this cross-sectional study.
Adiposity ; Adolescent ; Body Mass Index* ; Child* ; Cross-Sectional Studies ; Diagnosis ; Female ; Humans ; Male ; Mass Screening ; Obesity* ; Prevalence ; Seoul*

Esophageal intramural pseudodiverticulosis is a rare disease characterized by multiple, flask-shaped outpouchings in the esophageal wall. These pseudodiverticula represent abnormally dilated excretory ducts of esophageal submucosal gland, which cause is unknown. The most common symptom is dysphagia associated with esophageal stricture. Frequently associated diseases were gastroesophageal reflux disease, diabetes mellitus, candida esophagitis, and chronic alcoholism. We have experienced a patient with dysphagia and anemia, who was diagnosed as esophageal stricture with intramural pseudodiverticulosis and pancreatic pseudoaneurysm. He was treated with esophageal bougienage for the esophageal stricture and transcatheter embolization for pancreatic pseudoaneurysm. This may be the first case of esophageal intramural pseudodiverticulosis reported in Korea.
Alcoholism ; Anemia ; Aneurysm, False ; Candida ; Deglutition Disorders ; Diabetes Mellitus ; Esophageal Stenosis ; Esophagitis ; Gastroesophageal Reflux ; Humans ; Korea ; Rare Diseases