Chlorophenoxy herbicide poisoning is uncommon, but may produce severe sequelae. It's treatment is primarily the same as that used for poisonings with other drugs; gastric lavage, activated charcoal, etc. However, it's secondary treatment to enhance elimination has two options, alkaline diuresis or hemodialysis. We experienced a patient who had been poisoned with chlorophenoxy herbicide and had severe symptoms like comatose mentation, acute renal failure, rhadomyolysis, etc. The patient was treated by hemodialysis for 5 days and recovered from the acute state.
Acute Kidney Injury ; Charcoal ; Coma ; Diuresis ; Gastric Lavage ; Humans ; Poisoning ; Renal Dialysis*

No abstract available.
Carney Complex* ; Hyperplasia* ; Myxoma* ; Nevus, Blue* ; Testis*

No abstract available.
Classification* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive*

Peritoneal tuberculosis is a disease rarely seen nowadays. Its symptoms are easy fatigue, abdominal distension, intermittent abdominal pain and ascites. Its onset is insidious, which si-mulates symptoms of peritonitis or carcinomatosis. Peritoneal tuberculosis should be considered in the differential diagnosis when a Patient's symptoms and signs are ascites, ovarian tumor, vague abdominal pain and abdominal distension with high serum level of CA 125, an antigenic determinant of epithelial ovarian cancers. We have recently experienced a case of peritoneal tuberculosis with markedly elevated serum level of CA 125 in 54 year-old woman and report our case with a brief review of the literature.
Abdominal Pain ; Ascites ; Carcinoma ; Diagnosis, Differential ; Fatigue ; Female ; Humans ; Middle Aged ; Ovarian Neoplasms ; Peritonitis ; Peritonitis, Tuberculous*

Telepathology systems will be common systems in hospitals. The two systems were designed and implemented in web environments for test. One was implemented with the Common Object Request Broker Architecture (CORBA) technique. The other system was implemented in the form of ActiveX. The histopathological materials were stained by Hematoxylin and Eosin. By the Donpisha CCD camera attached to an Olympus BX-51 optical microscope 180 color images come to be acquired. For evaluation of the systems, transmission times and telediagnosis concordance rates were measured. Image processing ability was tested using two telepathology systems. For the local area test, system I using CORBA had measured image transmission times of 0.1 s, 0.2 s, and 0.4 s at the file sizes of 100 K byte, 900 K byte and 3.6 M byte respectively. Transmission times for system II using Component Object Model (COM) were slightly slower, ranging from 0.02 s to 0.05 s. In the long distance area test, system II transmission times were 0.5 s, 0.8 s, and 2.0 s. The overall concordance rate of telediagnosis for the 180 images was 78.3%. In this study, we compared our systems about image transmission, and processing for the further development of system configurations.
Eosine Yellowish-(YS) ; Hematoxylin ; Internet* ; Telepathology*

PURPOSE: Hepatic veno-occlusive disease (VOD) is a life-threatening complication occurring early after stem cell transplantation (SCT). Early diagnosis and effective treatment has not been established in severe VOD. Because there are few reports on VOD in Korean children, we evaluated the clinical characteristics of VOD following SCT in children. METHODS: We retrospectively reviewed the chart of all patients (n=116) receiving SCTs in CNUH Pediatric BMT center between May, 1991 and June, 2004. RESULTS: VOD developed in 11 patients (9.5%) (median age, 9.8 years; range, 2 to 13.9). Underlying diagnoses were ALL (n=3), severe aplastic anemia (n=3), AML (n=2), acute biphenotypic leukemia (n=1), neuroblastoma (n=1), and myelodysplastic syndrome (n=1). The median day of onset of VOD was D+9 (range, D-3 to D+19). VOD was classified as moderate in 5 and severe in 6 cases. Maximum level of serum total bilirubin was 2.9 mg/dL (range, 2.1 to 9.2) in moderate VOD and 7.3 mg/dL in severe VOD (range, 2.0 to 24.2) at D+18 (range, D-5 to D+59). We successfully treated VOD with various combinations including tPA and heparin (2/5, 40%), ursodeoxycholic acid (2/5, 40%), N-acetylcysteine (3/5, 60%), and defibrotide (1/2, 50%). All of 5 patients with moderate VOD survived at D+100 (range, 5.5+ to 66.6+ months). Five of 6 (83%) patients with severe VOD died within first 19 day from complications of VOD. CONCLUSION: This retrospective study showed that the incidence of VOD was 9.5%, and the mortality of severe VOD was still high which would necessitate early diagnosis, effective prevention and treatment.
Acetylcysteine ; Anemia, Aplastic ; Bilirubin ; Child ; Diagnosis ; Early Diagnosis ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Heparin ; Hepatic Veno-Occlusive Disease* ; Humans ; Incidence ; Leukemia, Biphenotypic, Acute ; Mortality ; Myelodysplastic Syndromes ; Neuroblastoma ; Retrospective Studies* ; Stem Cell Transplantation ; Ursodeoxycholic Acid

We report a Korean family case of beta-thalassemia minor and Hb Queens. This is the first case report of Hb Queens in Korea. A 43-year-old male and his four family members had beta-thalassemia minor which is very rare in Korea. Incidentally, an alpha chain variant with a high isoelectric point was also found in two other family members without clinical problems and was finally identified as alpha 34 (B15) Leu-Arg or Hemoglobin Queens.
Adult ; Arginine/genetics ; Female ; Hemoglobins, Abnormal/*genetics ; Humans ; Korea ; Leucine/genetics ; Male ; Pedigree ; beta-Thalassemia/blood/*genetics

Retrorectal cystic harmatoma; Tailgut cyst, is a rare congenital disease typically presented as presacral mass, and malignant change of this disease is extremely rare. Frequently, This disease is misdiagnosed or confused at initial time. So, we have a case of tailgut cyst and report the clinical symptom and the result. A 40-year-old woman has admitted at Severance hospital for the anal pain. About 6cm sized irregular cystic and solid mass in the retrorectal area involving coccygeal bone and right gluteal muscle tendon were detected in magnetic resonance image. Under the impression of malignant tailgut cyst, the patient underwent Hartmann's operation (abdomino-sacral approach) under the sacral resection (S4, 5). The pathology was adenocarcinoma (poorly differentiated) arising from a tailgut cyst involving rectal adventitia, gluteus muscle and sacral bone. For the following 4 months after the operation, The patient is doing well with no evidence of recurrence.
Adenocarcinoma* ; Adult ; Adventitia ; Female ; Humans ; Pathology ; Recurrence ; Tendons

PURPOSE: As the oncologic safety of coloanal anastomosis (CAA) has been proven by many other authors, the incidence of CAA following a ultra-low anterior resection has increased. The purpose of this study is to evaluate the functional outcomes and complications for patients who underwent an ultra-low anterior resection and CAA for distal rectal cancer. METHODS: 57 patients underwent CAA following an ultra-low anterior resection between July 1997 and November 2003. 44 patients, who were followed up for more than 6 month after diverting ileostomy repair were evaluated for recurrence pattern, complications, and functional outcomes. RESULTS: The median follow-up period was 32.0+/-22.8 (8~83) months. The mean age of the patients was 54.3+/-10.4 (23~74) years. The types of anastomosis were straight CAA (n=20) and J pouch CAA (n=37). The mean tumor size was 4.1+/-1.9 (2~8) cm, the mean distal resection margin was 1.3+/-0.9 (0.2~4) cm. Six months later, the anastomosis distance following diverting ileostomy repair was measured at 3.24+/-0.6 (2~4) cm from the anal verge. The complications were multiple fistulas (n=3), fistula with anal stenosis (n=1), local recurrence with anal stenosis (n=1), anal stenosis (n=7). Anal incontinence (Kirwan grade III) was noted in 14 patients, and bowel movements more than 6 times per day were observed in 16 patients. Overall recurrence occurred in 6 patients (13.6%). The 5-years survival rate was 84.4%, and the 5-year disease-free survival was 68.9%. CONCLUSIONS: Although CAA in patients with rectal cancer provides excellent long-term survival, a low risk of recurrence, in tolerable function, complications, and poor functional outcomes have been observed with CAA; therefore, the choice of this method should be considered carefully.
Colonic Pouches ; Constriction, Pathologic ; Disease-Free Survival ; Fistula ; Follow-Up Studies ; Hand* ; Humans ; Ileostomy ; Incidence ; Rectal Neoplasms* ; Recurrence ; Survival Rate

BACKGROUND: As a tumor marker, lactate dehydrogenase is widely used as a prognostic factor in malignant lymphomas and a therapeutic monitor in ovarian dysgerminoma. But in other tumors, the clinical role of lactate dehydrogenase is not clear yet. To investigate the role of LD as a tumor marker, we analyzed patients with various cancers and high LD level. METHODS: The serum LD level was assayed in the cancer patients who visited our hospital. For the patients with high LD level, isoenzyme was also assayed. The response of chemotherapy was classified according to the WHO criteria into remission, which covers complete and partial remission, stable disease and progressive disease. The relationship between the tumor response and the LD response was examined in terms of sensitivity, specificity and positive predictive value. RESULTS: A total of 100 cancer patients were found to have high LD level; among them, 76 patients underwent chemotherapy. There were 38 patients with LD increased and 38 patients with LD decreased after chemotherapy. No patient was in remission, 6 patients in stable disease, and 32 patients in progressive disease among 38 patients with increased LD level; 18 patients in remission, 10 patients in stable disease, and 10 patients in progressive disease among 38 patients with decreased LD level. The sensitivity of LD increase in the patients with tumor progression is 76.2%, the specificity 73.7%, and the positive predictive value 84.2%(71.4%, 25.0% and 76.9% respectively in stomach cancer patients). The sensitivity of LD decrease in the responsive patients is 100%, the specificity 65.5% and the positive predictive value 47.4%.(100%, 64.7% and 14.3% in stomach cancer patients respectively). The LD isoenzyme pattern was not specific in this study. CONCLUSION: Serum LD measurement may be helpful in monitoring tumor response, especially for stomach cancer, after chemotherapy.
Drug Therapy ; Dysgerminoma ; Humans ; L-Lactate Dehydrogenase ; Lactic Acid* ; Lymphoma ; Sensitivity and Specificity ; Stomach Neoplasms