Acute megakaryoblastic leukemia is a rare and rapidly fatal disease characterized by proliferation of megakaryocyte series and atypical megakaryocytes in the bone marrow. Acute megakaryoblastic leukemia is suspicious when 1) megakaryocyte in peripheral blood, mixture of large and small mononuclear megakaryoblast in the bone marrow 2) cytoplasmic budding in blast 3) myelofibrosis (dense medullary overgrowth of reticulin fibers) 4) PAS (+), ANAE (+), SBB (−), peroxidase (−) and which is confirmed by platelet peroxidase oxidation on electron microscope or monoclonal antibody. A case of acute megakaryoblastic leukemia was studied morphologically and monoclonal antibody.
Blood Platelets ; Bone Marrow ; Cytoplasm ; Leukemia, Megakaryoblastic, Acute* ; Megakaryocyte Progenitor Cells ; Megakaryocytes ; Naphthol AS D Esterase ; Peroxidase ; Primary Myelofibrosis ; Reticulin

PURPOSE: To evaluate the effects of a logotherapy program entitled 'Finding meaning in my life' for adolescents with terminal cancer. METHODS: A nonequivalent control group, non-synchronized design was conducted with a convenience sample of 44 late adolescents with terminal cancer. The experimental group (n=22) participated in the 'Finding meaning in my life' program which consisted of five-day sessions for one week. The control group (n=22) received the usual nursing care. The effects were measured using adolescent meaning in life (AMIL), and quality of life (QOL) scales. The collected data were analyzed by descriptive statistics, Chi-square, and t-test using SPSS/PC 17.0 program. RESULTS: There were significant differences in AMIL (t=3.36, p<.05) and QOL (t=2.67, p<.05) between the experimental and control groups. CONCLUSION: Logotherapy is effective in improving the meaning in life and quality of life of late adolescents with terminal cancer, and can be used to prevent existential distress.
Adolescent ; Demography ; Female ; Humans ; Male ; Neoplasms/psychology/*therapy ; Patient Education as Topic ; Program Evaluation ; *Psychotherapy ; Quality of Life ; Questionnaires ; Young Adult

Silicone fluid is a biomaterial widely used in modern cosmetic procedures because there are few side effects, considerable chemical stability and predictable physical properties. However, many local and systemic adverse reactions have reported. In particular some serious pulmonary complications have been reported such as pulmonary thromboembolism, acute respiratory distress syndrome with some cases leading to mortality. Most of the serious complicated cases were induced by an illegal silicone fluid injection. We experienced two cases of acute respiratory distress syndrome with pulmonary hemorrhage induced by an illegal silicone fluid injection. The patients were 41 & 51 year old women, who complained of dyspnea. The chest X-ray and HRCT scan findings showed a bilateral ground glass attenuation on the bilateral dependent portion of the upper and middle lung zone. The patients clinical symptoms and the radiologic and other laboratory findings were compatible with acute respiratory distress syndrome induced by the silicon fluid injection. Here we report two cases of acute respiratory distress syndrome with pulmonary hemorrhage induced by an illegal silicone injection with a review of the relevant literature.
Dyspnea ; Female ; Glass ; Hemorrhage* ; Humans ; Lung ; Mortality ; Perineum* ; Pulmonary Embolism ; Respiratory Distress Syndrome, Adult* ; Silicon* ; Silicones* ; Thorax

Collagenous colitis was first described by Lindstrom in 1976. Now this disorder is recognized as one of the more common causes of chronic diarrhea of obscure origin. This disorder is described as a disease of colon associated with chronic watery diarrhea and the typical histologic findings of a thickened subepithelial collagenous band. But in korea a few cases have been reported. We had observed a 52-year-old businessman with chronic watery diarrhea without abdominal pain in the past. And then we had reported previously that case. We also recently observed a 42-year-old housewife with chronic watery diarrhea with lower abdominal discomfort for 10 years. Colonoscopy disclosed no gross abnormalities through the entire colon ineluding the terminal ileum but we could find the pronounced thickening of subepithelial collageous band and chronic inflammation in the lamina propria in the histologic examination. We summarized the above two cases of collagenous colitis with a review of literatures.
Abdominal Pain ; Adult ; Colitis, Collagenous* ; Collagen* ; Colon ; Colonoscopy ; Diarrhea ; Humans ; Ileum ; Inflammation ; Korea ; Middle Aged ; Mucous Membrane

BACKGROUND: Osteoporosis in men is an important public health problem. Because of the tendency of the numbers of the elderly population to increase, and age-specific incidence of fractures, it is inevitable that the health burden due to fractures will increase. Chronic alcoholism is associated with other risk factors, such as poor nutrition, leanness, liver disease, malabsorption, vitamin D deficiency, hypogonadism, hemosiderosis, parathyroid dysfunction and tobacco use, and these may contribute to the pathogenesis of bone disease related to alcoholism. Chronic alcohol intake may reduce bone density, but can also increase bone density. It is well established that liver disease also induces bone density changes, thus it is difficult to distinguish the role of liver disease from that of alcohol itself in the bone alterations occurring in patients with chronic alcohol consumption. Chronic male alcoholics, not having liver cirrhosis were studied to assess the effect of chronic alcohol consumption on their bone mineral density. METHODS: The study subjects comprised of 18 chronic heavy drinkers of more than 40 g of alcohol per day for at least 3 years and 18 age-matched controls who drank less than 20 g of alcohol per day. The serum and urinary parameters of bone and mineral metabolism were determined. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at four axial sites (lumbar spine, femoral neck, Ward's triangle and trochanter). RESULTS: The alcoholic and control patients drank an average of 97.6 g and 7.2 g of alcohol per day. Osteocalcin, a marker of bone formation, was slightly decreased in alcoholic patients, and deoxypyridinoline, a marker of bone resorption, was slightly increased, but the difference was not statistically significant (p> 0.05). There were no differences between the two groups in the levels of free testosterone, estradiol, 25 (OH) vitamin D and parathyroid hormone. The Ward's triangle and trochanter BMDs of the femur were significantly lower in the alcoholics than the controls, and lumbar spine BMD was decreased in proportion to the total alcohol intake in the alcoholics (r=-0.625, p=0.01). CONCLUSION: We suggest that chronic alcohol consumption induces low bone density in the femur Ward's triangle and trochanter. There was also a significant inverse correlation between the lumbar spine BMD and the total amount of alcohol consumed. Large scaled randomized and prospective studies are needed to clarify the pathogenesis of alcohol-induced osteoporosis.
Alcoholism/*complications ; Blood Chemical Analysis ; *Bone Density ; Case-Control Studies ; Comparative Study ; Densitometry, X-Ray ; Human ; Male ; Middle Aged ; Osteoporosis/*etiology

BACKGROUND: The purpose of this study was to determine the genetic abnormalities of chromosomes 9p21, 17p13.1, 3p25 and 3p14.2 in the development and progression of astrocytic tumors. METHODS: We performed loss of heterozygosity (LOH) analysis in 41 astrocytic tumors, including 20 astrocytomas, 11 anaplastic astrocytomas and 10 glioblastomas, and correlated the results of LOH at different histopathologic grades. LOH was determined by multiplex polymerase chain reaction analysis of the DNA, which was extracted by microdissection. RESULTS: LOH of 9p21 was found in 55.6% of astrocytomas, 54.6% of anaplastic astrocytomas and 100.0% of glioblastomas. LOH of 17p13.1 was found in 21.4% of astrocytomas, 28.6% of anaplastic astrocytomas, and 66.7% of glioblastomas. LOH of 3p25 was found in 37.5% of astrocytomas, 16.7% of anaplastic astrocytomas, and 14.3% of glioblastomas. LOH of 3p14.2 was found in 16.7% of astrocytomas, 40.0% of anaplastic astrocytomas, and 42.9% of glioblastomas. LOH on chromosome 9p21 and 17p13.1 was closely related with the histopathologic grades. CONCLUSIONS: These results may suggest that LOH of 9p21, 17p13.1, 3p25 and 3p14.2 involves an early event of astrocytoma development and accumulates during progression. LOH of 3p25 may be involved in the tumorigenesis of astrocytoma. Identification of these LOH may illuminate the stepwise pathogenesis of astrocytic tumors and predict the possibility of malignant transformation.
Astrocytoma ; Carcinogenesis ; DNA ; Glioblastoma ; Humans* ; Loss of Heterozygosity* ; Microdissection ; Multiplex Polymerase Chain Reaction

OBJECTIVE: The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs). MATERIALS AND METHODS: From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. RESULTS: Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). CONCLUSION: The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Catheter-Related Infections/*epidemiology/microbiology ; Catheters, Indwelling/*adverse effects ; Female ; Hematologic Neoplasms/drug therapy ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms/drug therapy ; Palliative Care/statistics & numerical data ; Retrospective Studies ; Risk Factors ; Vascular Access Devices/*adverse effects ; Young Adult

BACKGROUND: Osteoporosis in men is an important public health problem. Because of the incremental tendency of elderly population and age-specific incidence of fracture, it is inevitable that the health burden of fracture will increase. Also, the mortality of fracture in men is higher than in women. Alcohol consumption is a risk factor for osteoporosis based on the frequent finding of a low bone mass decreased bone formation rate and increased fracture incidence in alcoholics. Chronic alcohol consumption may reduce bone density but also increase bone density. It has been well established that liver cirrhosis also induces bone density changes and thus it is difficult to distinguish the role of liver disease from that of alcohol itself in bone alterations occurring in patients with chronic alcohol consumption. So we studied male chronic alcoholics which did not have liver cirrhosis to assess the effect of chronic alcohol consumption on bone mineral density. METHODS: We studied 18 chronic heavy drinkers of more than 40 g/day for at least 5 years and age-matched 18 control groups who had drunk alcohol less than 20 g/day. Serum and urinary parameters of bone and mineral metabolism were determined. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at four axial sites (lumbar spine, femoral neck, ward's triangle and trochanter). RESULTS: Alcoholic patients drank alcohol 97.7 g/day. Osteocalcin, a marker of bone formation, was slight decreased in alcoholic patients and deoxypyridinoline, a marker of bone resorption, was slight increased but not statistically significant (p > 0.05). The levels of 25-(OH)-vit D, parathyroid hormone, free testosterone, estradiol were not different between the two groups. Ward's triangle and trochanter BMD of femur were significantly lower than controls and L-spine BMD decreased parallel with total alcohol intake amount in the alcoholics (r=-0.62, p < 0.05). CONCLUSION: We suggest that chronic alcohol consumption induced low bone density on femur ward and trochanter. And there was significant inverse correlation between L-spine BMD and total alcohol consumption amount. The large scaled randomized and prospective studies are needed to clarify the pathogenesis of alcohol-induced male osteoporosis.
Absorptiometry, Photon ; Aged ; Alcohol Drinking ; Alcoholics ; Alcoholism ; Bone Density* ; Bone Resorption ; Eating* ; Estradiol ; Female ; Femur ; Femur Neck ; Humans ; Incidence ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Male* ; Metabolism ; Mortality ; Multiple Endocrine Neoplasia Type 1 ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Parathyroid Hormone ; Public Health ; Risk Factors ; Spine ; Testosterone

The active metabolite of vitamin D, 1,25-dihydroxyvitamin D3 (calcitriol), inhibits the growth of several types of human cancer cells in vitro, but its therapeutic use is limited because it causes hypercalcemia. Among its analogs, 19-nor-1,25-dihydroxyvitamin D2 (paricalcitol), has fewer calcemic effects and exhibits an activity equipotent to that of calcitriol. We assessed the antitumor and anti-inflammatory effects of paricalcitol in gastric cancer cells, and evaluated the potential role of vitamin D in the treatment of peritoneal metastatic gastric cancer. In this study, treatment with paricalcitol inhibited gastric cancer cell growth and induced cell cycle arrest. Paricalcitol also induced apoptosis and showed anti-inflammatory activity. Moreover, the growth of intraperitoneal metastases in vivo was reduced in mice treated with paricalcitol. 18F-FDG uptake was significantly lower in the paricalcitol group compared to control group (SUV; control group 13.2 +/- 5.3 vs paricalcitol group 4.5 +/- 3.0). Intraperitoneal tumor volume was significantly lower in paricalcitol treated mice (control group 353.2 +/- 22.9 mm3 vs paricalcitol group 252.0 +/- 8.4 mm3). These results suggest that the vitamin D analog, paricalcitol, has anticancer activity on gastric cancer cells by regulation of the cell cycle, apoptosis, and inflammation.
Animals ; Antineoplastic Agents/chemistry/*pharmacology/therapeutic use ; Apoptosis/drug effects ; Cell Cycle Checkpoints/drug effects ; Cell Cycle Proteins/metabolism ; Cell Line, Tumor ; Cell Proliferation/drug effects ; Disease Models, Animal ; Ergocalciferols/chemistry/*pharmacology/therapeutic use ; Fluorodeoxyglucose F18/chemistry/diagnostic use ; Humans ; Mice ; Mice, Inbred BALB C ; Peritoneal Neoplasms/drug therapy/*secondary ; Positron-Emission Tomography ; Stomach Neoplasms/drug therapy/*pathology ; Transplantation, Heterologous

Organizing pneumonia is characterized histologically by the formation of granulation-tissue plugs within the lumens of small airways. It was reported in association with various disorders including infection, drug reactions and collagen vascular diseases. However, there have been only a few reports on organizing pneumonia accompanied by systemic lupus erythematosus (SLE), especially in the pediatric population. Herein, we report a case of an adolescent with SLE who initially developed respiratory illnesses due to organizing pneumonia. A 14-year-old girl was referred to our clinic for protracted cough with fever, dyspnea, and hemoptysis. Her chest x-ray revealed predominant multifocal consolidations in bilateral lung fields with pleural effusion. Computed tomography scan showed patchy consolidations with surrounding ground-glass opacities and a crazy paving appearance with multiple centrilobular nodules. Laboratory tests exhibited pancytopenia, elevated blood urea nitrogen and creatinine, proteinuria, low serum levels of complements, and positivity for antinuclear antibody and anti-double-stranded DNA antibody, which were suggestive of SLE. Lung biopsy was performed to exclude the possibility of vasculitis and other mixed connective tissue diseases, which confirmed focal organizing pneumonia. Systemic steroid therapy, including high-dose methylprednisolone, was started. After the treatment, her respiratory symptoms and radiologic findings showed significant improvements. The patient has been followed up so far, and she has remined disease-free. This pediatric case of organizing pneumonia as the initial presentation of SLE alerts clinicians to consider thorough assessment of pulmonary manifestations of SLE in children.