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*

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*

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

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

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

Primary Signet-ring-cell adenocarcinoma of the urinary bladder is an extremely rare variant that promotes considerable interest, 21 cases reported as of 1981. Morphologically, this tumor is identical to signet-ring-cell carcinomas of the gastrointestinal tract, breast, lung and nasal cavity, and differentiation must be carried out with great care. Characteristically, primary signet-ring-cell adenocarcinoma carries a poor prognosis with early penetration of the mucosa, submucosa, and muscularis. This tumor is sessile, infiltrates early, extends locally to adjacent organs, and metastasized late. Many patients reported died of local extension with ureteral obstruction and uremia rather than wide spread metastasis. We are reporting two cases of primary signet-ring-cell adenocarcinoma of the urinary bladder treated with radical cystectomy and transurethral resection with radiotherapy, which died of local extension with ureteral obstruction and uremia, with pathological findings and review of the literatures.
Adenocarcinoma* ; Breast ; Cystectomy ; Gastrointestinal Tract ; Humans ; Lung ; Mucous Membrane ; Nasal Cavity ; Neoplasm Metastasis ; Prognosis ; Radiotherapy ; Uremia ; Ureteral Obstruction ; Urinary Bladder Neoplasms ; Urinary Bladder*

PURPOSE: The management of local recurrence after curative surgery of the rectal cancer remains difficult clinical problems to surgeons. This study was performed to analyze the outcomes of patients with local pelvic recurrence according to its recurrence type. METHODS: A total 109 patients with local recurrence were evaluated. Among the 109 patients 62 were local recurrence alone and 47 were both local and systemic recurrence. The recurrence type was classified as Central, Anterior, Posterior, Lateral and Perineal recurrence according to the relation of the tumor location and either intra pelvic organ and/or fixed pelvic structure. RESULTS: Only 26 (23.9%) of the 109 patients had curative resection and the remaining 83 (76.1%) patients had palliative exploration or nonsurgical procedure. The resectability according to the recurrence type showed that the Central and Anterior type was higher than other type of recurrences (P=0.001). When the primary operation was Abdominoperineal Resection (APR) the resectability was poorer than Low Anterior Resection (LAR) (P=0.0001). When comparing the patients with local recurrence alone, the 5 year survival rate was significantly higher patients treated by curative resection than palliative or non-resection group (P=0.002). Mean follow up period was 44.2+/-30.0 months and mean recurrence time between primary operation and recurrence was 26.0+/-22.7 months. CONCLUSIONS: Resection for central type of the recurrent is potentially curative, however treatment failure was common when the recurrence invaded fixed pelvic structure. Our data suggest that local pelvic recurrence should be treated with radical resection as can as possible.
Classification* ; Follow-Up Studies ; Humans ; Prognosis* ; Rectal Neoplasms* ; Recurrence* ; Survival Rate ; Treatment Failure

Viral proteins of gamma-2 herpesviruses, such as LMP2A of Epstein Barr virus (EBV) and Tip of herpesvirus saimiri (HVS) dysregulate lymphocyte signaling by interacting with Src family kinases. K15 open reading frame of Kaposi's sarcoma associated herpesvirus (KSHV), located at the right end of the viral genome, encodes several splicing variants differing in numbers of transmembrane domains. Previously, we demonstrated that the cytoplasmic tail of the K15 protein interfered with B cell receptor signal transduction to cellular tyrosine phosphorylation and calcium mobilization. However, the detailed mechanism underlying this phenomenon was not understood. In the C-terminal cytoplasmic region of K15, putative binding domains for Src-SH2 and -SH3 were identified. In this study, we attempted to characterize these modular elements and cellular binding protein(s) by GST pull down and co-immunoprecipitation assays. These studies revealed that K15 interacted with the major B cell tyrosine kinase Lyn. In vitro kinase and transient co-expression assays showed that the expression of K15 protein resulted in activation of Lyn kinase activity. In addition, GST pull down assay suggested that the SH2 domain of Lyn alone was necessary for interaction with the C-terminal SH2B (YEEV) of K15, but the addition of Lyn SH3 to the SH2 domain increases the binding affinity to K15 protein. The data from luciferase assays indicate that K15 expression in BJAB cells induced NFAT and AP1 activities. The tyrosine residue in the C-terminal end of K15 required for the Lyn interaction appeared to be essential for NFAT/AP1 activation, highlighting the significance of the C-terminal SH2B of K15 as a modular element in interfering with B lymphocyte signaling through interaction with Lyn kinase.
Cell Line ; Herpesvirus 8, Human/genetics/*metabolism ; Humans ; Immunoblotting ; Immunoprecipitation ; Membrane Proteins/genetics/*metabolism ; NFATC Transcription Factors/genetics/*metabolism ; Phosphorylation ; Protein Binding ; Sarcoma, Kaposi/virology ; Transcription Factor AP-1/genetics/*metabolism ; Transfection ; Viral Proteins/genetics/*metabolism ; src-Family Kinases/genetics/*metabolism

Retrorectal tumors are particularly rare among the adult population, occurring in 1 of 40,000 hospital admissions. Clinical diagnosis is difficult and is often delayed because of vague symptoms. This study aimed to investigate the clinicopathological features of retrorectal tumors. Between January 1999 and March 2005, 10 patients were diagnosed with retrorectal tumors at the Department of Surgery, Yonsei University Medical Center, and their medical records were reviewed. We analyzed chief complaints, imaging studies, surgical approaches and pathologic examinations. Out of 10 patients, 8 were female and 2 were male. The mean age was 42.8 years. Four patients had no symptoms. Perianal and abdominal pain were the most common presentations. CT and MRI were the most frequently performed imaging studies. Surgery was performed in 9 patients. Postoperative pathologic diagnosis was possible in 9 patients. An epidermal cyst was the most common tumor (4 patients); others included a mature teratoma, an adenocarcinoma from a tail gut cyst, a duplication cyst, a neurogenic tumor, and a smooth muscle cell tumor. Imaging techniques like CT scans, MRI and TRUS are helpful to determine the size and the extent of a tumor and its relationship to the surrounding anatomical structures for the operative approach. A surgical resection is the standard of treatment and demonstrates good results and a good prognosis.
Abdominal Pain ; Academic Medical Centers ; Adenocarcinoma ; Adult ; Epidermal Cyst ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Myocytes, Smooth Muscle ; Prognosis ; Teratoma