A virus-associated hemophagocytic syndrome is characterized by high fever, liver dysfunction, coagulation abnormalities, pancytopenia, and a benign histiocytic proliferation with prominent hemophagocytosis in bone marrow, lymph node, spleen, and liver. Three phases of disease progression can be defined. In the first week, there is mild leukocytosis and myeloid hyperplasia in the marrow and the fever is resistant to antipyretics and antibiotics. In the second phase, usually corresponding to the 2nd to 3rd week of the illness, the fever persists and jaundice and hepatosplenomegaly may develop and the marrow now reveals the presence of atypical or transformed T lymphocytes and a scattering of histiocytes with hemophagocytosis. In the third phase, the disease progresses to a full-blown hemophagocytic syndrome with coagulopathy and lung infiltrates. The marrow in this stage is usually hypoplastic with florid histiocytic proliferation and hemophagocytosis and the patients usually die within 1-2 months. We describe a pregnant woman with fatal hemophagocytic syndrome. Virologic study strongly suggests that Epstein-Barr virus implicated in the pathogenesis of this patient.
Anti-Bacterial Agents ; Antipyretics ; Bone Marrow ; Disease Progression ; Female ; Fever ; Herpesvirus 4, Human* ; Histiocytes ; Humans ; Hyperplasia ; Jaundice ; Leukocytosis ; Liver ; Liver Diseases ; Lung ; Lymph Nodes ; Lymphohistiocytosis, Hemophagocytic* ; Pancytopenia ; Pregnancy* ; Pregnant Women ; Spleen ; T-Lymphocytes

The bcl-2 gene is a proto-oncogene which extends cell survival by blocking apoptosis. Bcl-2 expression has been detected in many types of nodal and MALT lymphoma. The p53 gene is a tumor suppressor gene and p53 mutation is the most common genetic alteration in human malignancies. The relationship between the expression of bcl-2 and p53 protein in primary gastric lymphoma has been rarely reported. The authors investigated the expression of bcl-2 and p53 protein in 37 cases of primary gastric lymphoma by immunohistochemical method using bcl-2 and p53 monoclonal antibodies. There were five cases of low grade B-cell MALT lymphomas and thirty two cases of high grade B-cell lymphomas. Fifteen of 37 cases (41%) showed bcl-2 protein expression in the cytoplasm of tumor cells and 26 cases (70%) showed p53 protein expression in the nucleus of tumor cells. Bcl-2 protein was detected in 4 of 5 (80%) low grade MALT lymphomas, and in 11 of 32 (34%) high grade lymphomas. There was no significant correlation between bcl-2 expression and histologic grade of primary gastric lymphomas (p>0.05). p53 protein was positive in 25 of 32 (78%) high grade lymphomas, and in 1 of 5 (20%) low grade MALT lymphomas. The expression of p53 protein is significantly higher in high grade lymphoma than in low grade MALT lymphoma (p<0.05). The p53 expression in the bcl-2 negative cases (86%) was significantly higher than in the bcl-2 positive cases (47%). There was an inverse relationship between bcl-2 and p53 expression in primary gastric lymphoma. These results suggest that bcl-2 and p53 expression in primary gastric lymphoma may be involved in the transition from low grade MALT lymphoma to high grade lymphoma.
Antibodies, Monoclonal ; Apoptosis ; B-Lymphocytes ; Cell Survival ; Cytoplasm ; Genes, bcl-2 ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Proto-Oncogenes

The importance of effective communication cannot be overestimated during a pandemic. The Korea Disease Control and Prevention Agency national 1339 hotline has been in operation since the Middle East respiratory syndrome coronavirus outbreak in 2016. The hotline is open 24 hours a day, 7 days a week, 365 days a year, and provides accurate, reliable information based upon the Korea Disease Control and Prevention Agency guidelines in response to queries. During the coronavirus disease 2019 (COVID-19) pandemic, the 1339 hotline received callers’ questions about symptoms and the implications of their actions regarding the epidemic. Through the 1339 hotline, callers received the upto-date information that enabled them to protect themselves as well as others from COVID-19. This public service may have influenced on reduced risk of virus transmission in Korea.

The importance of effective communication cannot be overestimated during a pandemic. The Korea Disease Control and Prevention Agency national 1339 hotline has been in operation since the Middle East respiratory syndrome coronavirus outbreak in 2016. The hotline is open 24 hours a day, 7 days a week, 365 days a year, and provides accurate, reliable information based upon the Korea Disease Control and Prevention Agency guidelines in response to queries. During the coronavirus disease 2019 (COVID-19) pandemic, the 1339 hotline received callers’ questions about symptoms and the implications of their actions regarding the epidemic. Through the 1339 hotline, callers received the upto-date information that enabled them to protect themselves as well as others from COVID-19. This public service may have influenced on reduced risk of virus transmission in Korea.

BACKGROUND: Smoking is a very dangerous behavior and people know that it will lead to fatal health problems. But, many people continue to smoke. We studied psychiatric aspect of smoking. METHODS: We distributed self-questionnaire to people who visited Dong-San Medical Hospital for periodical examination and checkups between the months of April and June, 1996. It consisted of inquiries on their smoking status and symptom check list for minor psychiatric disorders(SCL-MPD). Among the total of 147 men 58 were current smokers, 63 non-smokers, 26 ex-smokers. We compared minor psychiatric differences between each groups by Student t-test. RESULTS: The mean age of current smokers, ex-smokers and non-smokers were 44.9 +/-8.9, 44.8+/-8.4 and 46.6+/-9.6, respectively. Among 10 dimensions of SCL-MPD, the smokers (includes current smokers and ex-smokers) had significantly higher scores on anger-hostility, interpersonal sensitivity and obsessive-compulsive dimensions than those of non-smokers(p<0.05). When comparing with current smokers and non-smokers, current smokers had significantly higher scores on anger-hostility and obsessive-compulsive dimensions(p<0.05). Between ex-smokers and non-smokers, ex-smokers had significantly higher scores on anger-hostility and obsessive-compulsive dimensions(.p<0.05). But, no significant differences were observed between current smokers and ex-smokers. CONCLUSIONS: Smokers(current smokers and ex-smokers) were highly associated with anger-hostility, interpersonal sensitivity and obsessive-compulsive disorders compared to non-smokers. But, no minor psychiatric differences were observed between current smokers and ex-smokers.
Dangerous Behavior ; Humans ; Male ; Obsessive-Compulsive Disorder ; Smoke* ; Smoking*

OBJECTIVE: The aim of this study was to analyze significant motion factors that affected the outcome of medial branch blocking(MBB) in patients with low back pain(LBP) after trivial trauma. METHODS: Twenty-four patients(10men and 14 women; 70 vertebrae) complained of LBP after trivial trauma and under went bilateral MBB in the lumbar spine between January 2007 and August 2008. Visual Analogue Scale(VAS) scores of discomfort were measured before and after MBB. The motion factors considered were sitting, standing, flexion, extension and rotation. RESULTS: Sitting-, standing- and rotation-related LBPs were identified in 11 patients(44.5%, 11/24), 10 patients(41.7 %, 10/24) and 8 patients(33.3%, 8/24), respectively. The ratios of flexion- and extension-related LBPs in the enrolled patients were 66.7%(16/24) and 54.2%(13/24), respectively. The reduction in VAS score after treatment in the patients with sitting-related LBP was less than that of patients without sitting-related LBP(3.2+/-2.27 and 5.2+/-2.87, p=0.169). There was no difference between patients with standing-related LBP and those without(4.3+/-2.75 and 4.3+/-2.86). Although the mean VAS score improvement of the patients with extension- and rotation-related LBP(4.4+/-2.99 and 5.4+/-2.67) was higher than that of patients without extension and rotation LBP(4.1+/-2.59 and 3.7+/-2.71), the difference was not significant(p=0.721 and p=0.552, respectively). The mean VAS score improvement of the patients with flexion- related LBP was significantly higher than that of patients without it(6.1+/-1.81 vs 2.8+/-2.59, p=0.042). CONCLUSIONS: In patients with LBP after trivial trauma, flexion- and extension-related LBP was more common than sitting-, standing- and rotation-related LBP. Flexion was a significant motion factor affecting the outcome of MBB after trivial trauma.
Humans ; Low Back Pain ; Spine

Necrotizing enterocolitis (NEC) is an acute fulminating disease of neonate characterized by diffuse or patchy intestinal necrosis accompanied by sepsis and often followed by perforation, peritonitis and death. We had experienced 2 cases of NEC recently which were diagnosed by clinical, X-Ray survey, histologic finding of operation. Review of the references concerning NEC was made briefly.
Enterocolitis, Necrotizing* ; Humans ; Infant, Newborn ; Necrosis ; Peritonitis ; Sepsis

PURPOSE: The purpose of this study was to investigate the prognostic significance of the expression of EGFR and C-erbB-2 gene products by immunohistochemical analysis for curatively resected gastric adenocarcinoma. MATERIALS AND METHODS: Between January 1996 and December 2001, 739 patients with curatively resected gastric cancer patients underwent Immunohistochemical staining for EGFR and C-erbB-2 proteins, and we retro spectively analyzed their correlation with the clinical outcome. RESULTS: The overexpressions of EGFR and C-erbB-2 were 25.4% and 26.2%, respectively. The overexpressions of EGFR was associated with the more poorly differentiated tumor (p=0.000) and with neuronal invasion (p=0.03). Overexpression of C-erbB-2 was associated with less vascular invasion (p=0.001). Tumor depth or node metastasis was not related to the overexpression of EGFR or C-erbB-2. The seven-year overall survival and relapse-free survival rates were 87.2% and 75.8%, respectively. Upon multivariate Cox regression analysis, the tumor stage, tumor size and patient age were important prognostic factors for overall survival, and tumor stage was the important factor for relapse-free survival. Overexpressions of EGFR or c-erbB-2 were not significant prognostic factors. CONCLUSION: Immunohistochemical staining of EGFR and C-erbB-2 gene products were not independent prognostic factors for predicting the overall survival and the relapse-free survival in curatively resected gastric cancer.
Adenocarcinoma ; Genes, erbB-2 ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Neurons ; Prognosis ; Receptor, erbB-2 ; Regression Analysis ; Stomach Neoplasms*

Most osteosarcomas arise spontaneously, but rarely they may be secondary to other benign osseous conditions and may occur following irradiation. Postradiation sarcoma of bone is approximately 5.5 percent of all osteogenic sarcoma. Diagnosis is possible when a sarcoma arising after long latent period(more than 3 years) in irradiated bone and the bone is normal or benign osseous lesion at the time of irradiation. The spontaneously arising osteogenic sarcomas are distribute mainly in the knee region, but postradiation sarcoma arise in any bones, such as long bone of the extremity, pelvic bone, vertebra, craniofacial bone and shoulder girdle bone. Recently we experienced a case of postradiation osteosarcoma of the pelvic bone who received radiation therapy for carcinoma of the uterine cervix 20 years ago.
Cervix Uteri ; Diagnosis ; Extremities ; Female ; Knee ; Osteosarcoma* ; Pelvic Bones* ; Sarcoma ; Shoulder ; Spine

Mesenteric cysts are uncommon, and they are histopathologically classified as pseudocyst, mesothelial cyst, lymphangioma and omental cyst. We report a case of a 27-year-old female with a huge cystic mass arising from greater omentum. Patient complained the symptoms of abdominal distention due to massive ascites and intermittent pelvic discomfort. The diagnostic examinations including ultrasonography and computed tomography were performed and identified a huge, intraabdominal cyst. Laparoscopic resection of cyst was done with no clinical and symptomatic evidence of adverse event till 12 months. The diagnostic role of sonography and CT in ascites with unknown etiology is emphasized. Minimal invasive surgery showed comparable result to open exploration.
Adult ; Ascites ; Female ; Humans ; Laparoscopy ; Lymphangioma ; Mesenteric Cyst ; Omentum