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.

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

OBJECTIVES: The purpose of this study was to investigate the work loss caused by oral diseases of workers and their subjective self-perceived oral health status. The study focused on the relationship between work loss due to oral diseases and self-perceived oral health status. METHODS: A cross-sectional survey was conducted. The sample consisted of 550 workers who resided in Ansan City and Gwacheon City. The data were collected from a self-reported questionnaire survey. RESULTS: The percentage of workers that were absent from the workplace due to oral diseases in the past year was 4.8%, and the average of days of absence from the workplace per worker was 0.1 day. Most of the workers (41.1%) answered “average” for the self-perceived oral health status. However, there were more workers that answered “not healthy” than workers that answered “healthy” for the self-perceived oral health status. The percentage of workers that felt the need for dental treatment because of the presence of oral diseases was 59.5%. There was a statistically significant relationship between the work loss due to oral diseases and the subjective self-perceived oral health status. CONCLUSIONS: Work loss due to oral diseases and subjective self-perceived oral health status should be periodically assessed for use as basic data for the development of oral health-promotion policies for workers.
Cross-Sectional Studies ; Gyeonggi-do ; Oral Health*

BACKGROUND: Carcinoma of the esophagus traditionally has been treated with surgery or radiation therapy. The aim of this study was to assess the effect and safety of chemoradiation therapy on patients with advanced esophageal cancer. METHODS: We performed a retrospective study of twenty eight cases with inoperable carcinoma of the esophagus treated with definitive chemoradiation at single institute between April 2001 and December 2004. Twenty eight patients with esophageal squamous cell carcinomas were treated with concurrent chemoradiation therapy. Of 28 patients, 22 had stage III disease, 6 had stage II disease, and 26 were males and 2 were females. The median age of the patients was 63.0 years (range, 4475 years). The regimen involved four cycles of chemotherapy, cisplatin, 75 mg/m2 intravenously on the first day of weeks 1, 5, 9, and 13, and 5-fluorouracil, 1,000 mg/m2 per day on the first 4 days of weeks 1, 5. 9. and 13, concurrently with a dose of 5,400 cGy external beam radiotherapy. RESULTS: The overall response rate was 89%. The median overall survival was 24.7 months, the 1-year and 3-year overall survival rate was 71% and 32%, respectively. The 1-year and 3-year progression-free survival rate was 86% and 54%, respectively. Grade 3/4 hematological toxicities included neutropenia in 50% of the patients, anemia in 25%, and thrombocytopenia in 14%. Grade 3 and 4 non-hematological toxicities were less common. CONCLUSIONS: These results suggest that concurrent chemoradiotherapy is an effective regimen.
Anemia ; Carcinoma, Squamous Cell ; Chemoradiotherapy* ; Cisplatin ; Combined Modality Therapy ; Disease-Free Survival ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Female ; Fluorouracil ; Humans ; Male ; Neutropenia ; Radiotherapy ; Retrospective Studies ; Survival Rate ; Thrombocytopenia

BACKGROUND: The purpose of this study was to clarify whether the patients' age is an independent prognostic factor in curatively resected gastric adenocarcinoma. METHODS: Clinicopathologic information was reviewed for consecutive patients undergoing curative gastrectomy for gastric cancer during 6-year period (Jan. 1996-Dec. 2001) at the Keimyung University School of Medicine at Daegu. Overall survival was examined by the Kaplan-Meier method, and multivariate analysis by Cox proportional hazards was used to identify whether age had independent prognostic significance for survival. RESULTS: The patients were divided into two groups: 838 patients (72.4%) with age of less than 65 years old, and 320 patients (27.6%) with age more than 65 years old. In these two groups, there were statistically differences in WHO classification, Lauren classification, vascular invasion, T stage, total stage, operational morbidity and mortality, and overall survival rate. The 5-year overall survival rate of age less than 65 years old was 87.8%, and 83.0% of age more than 65 years old (p=0.019). Multivariate Cox regression analysis revealed that age was an independent prognostic factor to predict overall survival in curatively resected gastric cancer (p=0.038). However, after excluding cases who died within 1 month after gastric resection, overall survival rate was significantly different between two groups (p=0.050), but Cox regression analysis showed that age was not an independent prognostic factor (p=0.054). CONCLUSION: The age is not an independent prognostic factor in curatively resected gastric cancer patients, and survival differences are due to an increased operative mortality in elderly patients.
Adenocarcinoma ; Aged ; Classification ; Daegu ; Gastrectomy ; Humans ; Mortality ; Multivariate Analysis ; Prognosis ; Stomach Neoplasms* ; Survival Rate