When a patient with malignant lymphoma develops new lymph node enlargement, a recurrence of lymphoma is usually suspected first. However, painless and rapid lymph node enlargement, a manifestation of non-Hodgkin’s lymphoma, could also be due to other causes. A 3-year-old boy who was previously diagnosed with Burkitt lymphoma was admitted for routine tumor evaluation one year following completion of treatment. Abdominal computed tomography showed several enlarged lymph nodes in the right lower quadrant, and 18 F-fluoro-2-deoxy-D-glucose positron emission tomography revealed hypermetabolic enlarged lymph nodes in the corresponding lesion. The patient underwent ileocecal lymph node biopsy for pathologic confirmation, which revealed reactive hyperplasia without lymphoma recurrence. Serologic test results for cytomegalovirus immunoglobulin G and immunoglobulin M were positive. Additionally, the polymerase chain reaction test performed using a urine sample was positive for cytomegalovirus. After several outpatient follow-ups, we concluded cytomegalovirus infection that mimicked a recurrence of lymphoma on imaging as the cause for lymph node enlargements. This case highlights the importance of using prompt and multiple approaches after detecting a possible tumor recurrence through imaging studies.

When a patient with malignant lymphoma develops new lymph node enlargement, a recurrence of lymphoma is usually suspected first. However, painless and rapid lymph node enlargement, a manifestation of non-Hodgkin’s lymphoma, could also be due to other causes. A 3-year-old boy who was previously diagnosed with Burkitt lymphoma was admitted for routine tumor evaluation one year following completion of treatment. Abdominal computed tomography showed several enlarged lymph nodes in the right lower quadrant, and 18 F-fluoro-2-deoxy-D-glucose positron emission tomography revealed hypermetabolic enlarged lymph nodes in the corresponding lesion. The patient underwent ileocecal lymph node biopsy for pathologic confirmation, which revealed reactive hyperplasia without lymphoma recurrence. Serologic test results for cytomegalovirus immunoglobulin G and immunoglobulin M were positive. Additionally, the polymerase chain reaction test performed using a urine sample was positive for cytomegalovirus. After several outpatient follow-ups, we concluded cytomegalovirus infection that mimicked a recurrence of lymphoma on imaging as the cause for lymph node enlargements. This case highlights the importance of using prompt and multiple approaches after detecting a possible tumor recurrence through imaging studies.

PURPOSE: To evaluate the clinical efficacy and histopathological tolerance of 2-octyl cyanoacrylate versus conventional suture materials for eyelid wound closure in rabbits. METHODS: We performed an experimental study on 16 eyes of eight New Zealand albino rabbits. Eyelid incisions of 15 mm were done 4mm from the upper eyelid margin in both eyes. The eyes of the rabbits were divided into two groups: eyelid incisions of the right eye were closed by a 2-octyl cyanoacrylate adhesive (group A) and eyelid incisions of the left eye were closed by 7-0 nylon sutures (group B). At 1, 2, 4, and 8 weeks after surgery, the rabbits were macroscopically examined and then sacrificed. The specimens of their eyelid tissues were stained by a hematoxylin and eosin stain and Masson-trichrome stain, and were observed under microscope. RESULTS: Both eyelid surgical closure methods were found to be equally efficacious in fixing the eyelids of groups A and B, and their clinical efficacy was similar. Histopathological findings of the hematoxylin and eosin stain of group A showed less inflammatory infiltration than group B at 2 weeks. There were no significant histopathological differences between the two groups at 1, 4, and 8 weeks. The degree of fibrosis of the Masson-trichrome stain was similar between the two groups at 8 weeks. CONCLUSIONS: The 2-octyl cyanoacrylate adhesive proved to be an effective eyelid closure method and was very well tolerated by the skin surface. 2-Octyl cyanoacrylate could be used as an alternative tissue adhesive for eyelid wound closure along with conventional suture materials.
Animals ; Blepharoplasty/*methods ; Cyanoacrylates/*pharmacology ; Disease Models, Animal ; Eyelid Diseases/pathology/*surgery ; Eyelids/*surgery ; Rabbits ; Suture Techniques/*instrumentation ; *Sutures ; Tissue Adhesives/*pharmacology ; Treatment Outcome ; Wound Healing

BACKGROUND: Gastric cancer remains the main cause of cancer-related death in Korea. Accurate preoperative staging of gastric cancer is essential to predict prognosis and to plan optimal treatment. Although there are many reports dealing with the diagnostic values of conventional methods, controversies are still present especially in the field of preoperative staging. In this study, we evaluated the accuracy of gastroscopy and upper gastrointestinal series(UGI) for diagnosis of gastric cancer, and determined the usefulness of ultrasonography and computed tomography for preoperative staging. METHODS: One hundred twenty-three patients, who underwent operation from Aug. 1991 to Mar. 1995 under the diagnosis of gastric cancer were analyzed. We excluded 15 patients because their postoperative definitive stagings were undetemined. RESULTS: 1) Among 123 patients, the proportion of early gastric cancer was 26.0%(32/123) and that of the advanced gastric cancer was 74.0%(91/123). 2) The sensitivity of endoscopic diagnosis of gastric cancer was 96.7%(119/123), and the accuracy to determine the depth of invasion was 82.9% (102/123). 3) The sensitivity of UGI study for gastric cancer was 89.9%(98/109), and the accuracy to determine the depth of invasion was 61.5%(61/109). 4) The sensitivity of abdominal ultrasonography to detect the tumor was 11.3%(8/71), the accuracy to determine the T stage was 29.2%(28/96), and the sensitivity and specificity to detect lymph node metastasis was 13.6%(8/59), 100%(37/37), respectively. 5) The sensitivity of abdominal CT to detect the tumor was 74.3%(26/35), the accuracy to determine the T stage was 32.5%(13/40), and the sensitivity and specificity to detect lymph node metastasis were 34.5%(9/29), 72.7%(8/11), respectively. 6) The accuracy of preoperative staging was 45.5%(56/123). The 49.6%(62/123) of gastric cancer was downstaged, whereas only 4.1%(5/123) was overstaged. CONCLUSION: Our results show that high accuracy for diagnosis of gastrie cancer with the gastroscopy and UGI. However preoperative staging with ultrasonography and computed tomograpy was often underestimated, which could be concluded that the usefulness of the radiologic methods was limited.
Diagnosis* ; Gastroscopy ; Humans ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography

We report a case of cavernous hemangioma of the anterior mediastinum that was incidentally detected by chest radiography taken at a routine health check-up. A mass lesion was seen in the anterior mediastinum on computed tomography and magnetic resonance imaging. Direct surgical removal was performed for diagnosis and treatment through right thoracotomy. Histopathology confirmed the mass as a cavernous haemangioma. Post-operative course was uneventful.
Caves ; Hemangioma ; Hemangioma, Cavernous ; Magnetic Resonance Imaging ; Mediastinum ; Thoracotomy ; Thorax

Vascularized composite allotransplantation for the forearm is a complex surgical procedure, requiring multidisciplinary collaboration. It is important to provide optimal blood flow to the grafts, effective immunosuppression, and early rehabilitation for graft survival and good functional outcomes. As ischemia-reperfusion injury and substantial but unquantifiable blood loss are inevitable in this type of surgery, anesthetic management should focus on providing adequate hemodynamic management with proper monitoring, and anesthetic and analgesic strategies to prevent vasoconstriction in the graft. In this paper, we describe the anesthetic management of the first forearm transplantation performed in Korea.
Anesthesia ; Cooperative Behavior ; Fluid Therapy ; Forearm ; Graft Survival ; Hemodynamics ; Immunosuppression ; Korea ; Rehabilitation ; Reperfusion Injury ; Transplants ; Vascularized Composite Allotransplantation ; Vasoconstriction

Vascularized composite allotransplantation for the forearm is a complex surgical procedure, requiring multidisciplinary collaboration. It is important to provide optimal blood flow to the grafts, effective immunosuppression, and early rehabilitation for graft survival and good functional outcomes. As ischemia-reperfusion injury and substantial but unquantifiable blood loss are inevitable in this type of surgery, anesthetic management should focus on providing adequate hemodynamic management with proper monitoring, and anesthetic and analgesic strategies to prevent vasoconstriction in the graft. In this paper, we describe the anesthetic management of the first forearm transplantation performed in Korea.

The gastrointestinal rnanifestations associated with antiphospholipid antibodies include Budd-Chiari syndroame, hepatic infarction, portal hypertension, pancreatitis, intestinal infarction, perforation, bleeding and ulceration. A 40-year old man, without prior thrombotic event, presented with severe abdominal pain for 3 days and septic shock. Multiple mesenteric venous thrombosis and colonic congestion were suggested by abdominal CT and angiography. Gastroendoscopy revealed esophageal varix and congestive gastropathy. Laboratory tests disclosed postive antiphospholipid antibodies, anti-HCV antibodies, HCV-PCR, prolonged PT, aPTT, thrombocytopenia and had no evidences of SLE and other connective tissue diseases. He was diagnosed as mutiple mesenteric thrombosis and portal hypertension associated with antiphospholipid antibodies in hepatitis C virus infection. He was improved with the antibiotics and intravenous vasopressors. He have had no other thrombotic events until one year after discharge.
Abdominal Pain ; Adult ; Angiography ; Anti-Bacterial Agents ; Antibodies, Antiphospholipid ; Colon ; Connective Tissue Diseases ; Esophageal and Gastric Varices ; Estrogens, Conjugated (USP) ; Hemorrhage ; Hepacivirus ; Hepatitis C Antibodies ; Hepatitis C* ; Hepatitis* ; Humans ; Hypertension* ; Hypertension, Portal ; Infarction ; Pancreatitis ; Shock, Septic ; Thrombocytopenia ; Thrombosis* ; Tomography, X-Ray Computed ; Ulcer ; Venous Thrombosis

BACKGROUND/AIMS: Cyclophosphamide (CP) is a promising treatment for severe cases of paraquat (PQ) poisoning. We investigated the effective dose of CP for mitigating PQ-induced lung injury. METHODS: Adult male Sprague-Dawley rats were allocated into five groups: control, PQ (35 mg/kg, intraperitoneal injection), and PQ + CP (1.5, 15, or 30 mg/kg). The dimensions of lung lesions were determined using X-ray microtomography (micro-CT), and histological changes and cytokine levels were recorded. RESULTS: The micro-CT results showed that 15 mg/kg CP was more effective than 1.5 mg/kg CP for treating PQ-induced lung injury. At a dose of 1.5 mg/kg, CP alleviated the histological evidence of inflammation and altered superoxide dismutase activity. Using 15 mg/kg CP reduced the elevated catalase activity and serum transforming growth factor (TGF)-beta1 level. CONCLUSIONS: A CP dose of > 15 mg/kg is effective for reducing the severity of PQ-induced lung injury as determined by histological and micro-CT tissue examination, possibly by modulating antioxidant enzyme and TGF-beta1 levels.
Animals ; Catalase/metabolism ; Cyclophosphamide/*pharmacology ; Cytokines/metabolism ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Immunosuppressive Agents/*pharmacology ; Inflammation Mediators/metabolism ; Lung/*drug effects/metabolism/pathology/radiography ; Lung Injury/chemically induced/diagnosis/*drug therapy/metabolism ; Male ; Oxidative Stress/drug effects ; *Paraquat ; Pulmonary Edema/chemically induced/diagnosis/*drug therapy/metabolism ; Rats ; Rats, Sprague-Dawley ; Severity of Illness Index ; Superoxide Dismutase/metabolism ; Transforming Growth Factor beta1/metabolism ; X-Ray Microtomography

BACKGROUND/AIMS: The aim of this study was to ascertain the effects of two week treatment of omeprazole (O) and clarithromycin (C) with and without metronidazole (M), and one week treatment of omeprazole, clarithromycin and metronidazole, for the eradieation of Helicobacter pylori (H. pylori) in patients with peptic ulcer disease in double-blind, randomly controlled groups. METHODS: The H. pylori infection determined in patients whose results were positive in a rapid urease test or in those who exhibited histology in antrum and body, The OC14 group received O 40 mg qd and C 500 mg t.i.d. for 2 weeks; the OCM14 group received O, C, and M 250 mg t.i.d for 2 weeks, and the OCM7 group received O, C, M for 1 week, respectively. H. pylori eradication was assessed 4 weeks after the end of treatment. The H. pylori eradication was determined as all negative for the rapid urease test and histology on both the antrum and body.
Clarithromycin* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metronidazole* ; Omeprazole* ; Peptic Ulcer* ; Urease