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.

Rhabdomyosarcoma (RMS) comprises of heterogeneous group of neoplasms that occasionally express epithelial markers on immunohistochemistry (IHC). We herein report the case of a patient who developed RMS of the skull with EWSR1 fusion and anaplastic lymphoma kinase (ALK) and cytokeratin expression as cytomorphologic features. A 40-year-old man presented with a mass in his forehead. Surgical resection was performed, during which intraoperative frozen specimens were obtained. Squash cytology showed scattered or clustered spindle and epithelioid cells. IHC revealed that the resected tumor cells were positive for desmin, MyoD1, cytokeratin AE1/ AE3, and ALK. Although EWSR1 rearrangement was identified on fluorescence in situ hybridization, ALK, and TFCP2 rearrangement were not noted. Despite providing adjuvant chemoradiation therapy, the patient died of tumor progression 10 months after diagnosis. We emphasize that a subset of RMS can express cytokeratin and show characteristic histomorphology, implying the need for specific molecular examination.

An intrauterine device (IUD) is one of the most commonly used contraceptive method in the world. One of the major complications of intrauterine contraception is the perforation through the uterine wall into the pelvic or abdominal cavity. The incidence is 0.9 people per 1000. However, bladder perforation is even more rare. It happens mostly at the time when it was inserted. The symptom varies from no symptom at all to low abdominal pain, massive bleeding, et cetera. We report a case with displaced intrauterine device in bladder, producing the bladder stone which was managed with cystoscopic lithotripsy and intrauterine device removal, followed by a review of the literature.
Abdominal Cavity ; Abdominal Pain ; Contraception ; Copper* ; Hemorrhage ; Incidence ; Intrauterine Devices* ; Lithotripsy ; Urinary Bladder ; Urinary Bladder Calculi ; Uterine Perforation

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

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*

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

STATEMENT OF PROBLEM: The adjustable dental impression trays were made for being adjusted their width automatically along the width of dental arch. PURPOSE: The purpose of this study was to investigate the best retentive form of adjustable dental impression tray, and so to make it a more satisfactory product. MATERIALS AND METHODS: The eight pairs of adjustable trays were made of ABS(acrylonitrile butadiene styrene) with different distribution of holes and with or without the rim on the border area of them. The experiment was done with the horse-shoe shaped metal plate to pull out the set impression body from the tray, and the tray jig which was made for holding the tray on a lower part of Universal Testing achine(UTM, Zwick Z020, Zwick Co., Germany). After the impression in the tray was allowed to set four minutes, a tensile force was applied at right angles to the tray which had been previously seated on the jig. The force was applied to measure a maximum retentive force by use of a UTM at a constant strain rate of 100mm per minute. A 2-factor analysis of variance (p<.05) was used to determine whether differences existed among distribution of retentive holes and between rim existing and not. RESULTS: 1. The retentive force of the upper and lower resin tray with 2mm holes on the tray border was highest(25.83/24.98kg).(p<.05) 2. As the tray had more retentive holes, it was less retentive. 3. There was no significant difference in the retentive force of the varied hole intervals in the case of distributing all the area.(p>.05) 4. The rimless trays were more retentive generally, than the rimmed trays except 2 case: upper tray group-all area / 2 mm. intervals and lower tray group-margin only / 2 mm. intervals.(p<.05) 5. Most of the adjustable trays were showed higher retentive force than perforated metal tray except the lower group that perforated on the all area at intervals of 2 mm.
Dental Arch