Balloon cell malignant melanoma (BCMM) is a rare histologic variant of malignant melanoma, which is composed either predominantly or entirely of large clear or foamy cells. The incidence of balloon cell malignant melanoma is about 0.15% of all cutaneous malignant melanomas. Recently, we experienced a case of cutaneous balloon cell malignant melanoma in the right lower abdomen with right inguinal and both axillary lymph node metastasis in a 56-year-old man. The cutaneous lesion was 4.5 3.5 cm in size, a well-demarcated black nodular mass, involving abdominal skin and subcutaneous tissue. The tumor was histologically composed of two types of tumor cells: predominant clear cell and focal, pigmented spindle cell. The nodal lesion was composed entirely of clear cells. Both clear and spindle cells showed positive reaction for S-100 protein and HMB-45 on immunohistochemistry.
Abdomen ; Humans ; Immunohistochemistry ; Incidence ; Lymph Nodes ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; S100 Proteins ; Skin ; Subcutaneous Tissue

During 1964 to 1967, a survey of 30,534 persons for filariasis was made on all over the country with the following results: Among 24,816 draftees from all over the country in the army recruitment camp 155(0.63 %) were found infected with Brugia malayi. Cheju Do showed the highest microfilaria rate(3.5 %), North Kyongsang Do(1.4 %) the next and South Cholla Do(1.2 %) the third. Blood films from 2,308 inhabitants were examined and 407(17.6 %) showed microfilaria in Cheju Do. 30(3.1 %) out of 974 inhabitants in North Kyongsang Do were found to be infected. The microfilaria rates were 2.0 per cent for 400 inhabitants of Chindo island in South Cholla Do. However, no positive case of microfilaria was found in the inhabitants of Kokumdo among 1,820 persons examined in South Cholla Do and of Namhae island(among 165 persons examined) in South Kyongsang Do. The mean microfilarial density per 20 cu. mm of blood was 52.6 in the inhabitants of Cheju Do, 12.2 in North Kyongsang Do and 27.3 in Chindo island(South Cholla Do). Any distinct relationship between the incidence of positive cases of microfilariae and age or sex of the cases was not observed in Cheju Do. However, in Norh Kyongsang Do and South Cholla Do the microfilaria rate of the male group is higher than the one of the female group of the inhabitants. From the above survey results it turned out that filariasis was found throughout Southern Korea except Kyonggi Do and South Kyongsang Do. A total 30,534 persons examined, 601(2.0 %) were found to be infected by Brugia malayi. Therefore, it seems that there are some endemic foci of malayian filariasis in three main areas such as North Kyongsang Do, South Cholla Do and Cheju Do.
parsitology-helminth-nematoda-Brugia malayi ; filariasis ; epidemiology ; Army

Lipoid pneumonia is chronic, interstitial, proliferative inflammation resulting from aspiration of lipoid material. Mineral oil is a hydrocarbon that physicians often use to treat chronic constipation in children and adults. Mineral oil may not elicit a normal protective cough reflex and may impair mucociliary transport. We experienced a case of exogenous lipoid pneumonia caused by aspiration of mineral oil given as a laxatives confirmed by fiberoptic bronchoscopy with bronchoalveolar lavage and bronchial biopsy in a 9-month-old boy with chronic cough and radiologic evidence of parenchymal lung disease.We reported this case with a brief review of related literatures.
Adult ; Biopsy ; Bronchoalveolar Lavage ; Bronchoscopy ; Child ; Constipation ; Cough ; Humans ; Infant ; Inflammation ; Laxatives* ; Lung ; Male ; Mineral Oil ; Mucociliary Clearance ; Pneumonia* ; Reflex

PURPOSE:Aeroallergens are generally known to us as risk factors for the persistence of asthma. House dust mites are major aeroallergens in Korea. However, the associations between house dust mites sensitization, bronchial hyperresponsiveness and pulmonary function are still controversial. METHODS:One hundred eighteen children aged 5-12 years with mild to moderate asthma were enrolled. Each subject underwent the pulmonary function test, the methacholine challenge test, and the skin prick test with aeroallergens, and total serum immunoglobin (Ig)E levels. The non-sensitization group was defined when skin prick test results are all negative for common aeroallergens. The sensitization group was defined when skin test results are positive for Dermatophagoides pteronyssinus or Dermatophagoides farinae. RESULTS:In the house dust mites sensitization group, increased serum total IgE and decreased methacholine PC(20) were noted. There was no significant difference in pulmonary functions between sensitization and non-sensitization groups. In the sensitization group, methacholine PC(20) correlated with prebronchodilator %FEF(25-75%) (r=0.346, P=0.008) but did not correlate with %FVC, %FEV(1) and FEV(1)/FVC. In the sensitization group, methacholine PC(20) and pulmonary function did not correlate with total IgE or age. CONCLUSION:The house dust mites sensitization in asthmatic children correlated with increased bronchial responsiveness but did not correlate with decreased pulmonary functions. These findings support the role of house dust mite sensitization in the modulation bronchial responsiveness.
Asthma ; Bronchial Hyperreactivity ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust* ; Humans ; Immunoglobulin E ; Korea ; Lung* ; Methacholine Chloride ; Pyroglyphidae* ; Respiratory Function Tests ; Risk Factors ; Skin ; Skin Tests

PURPOSE:Aeroallergens are generally known to us as risk factors for the persistence of asthma. House dust mites are major aeroallergens in Korea. However, the associations between house dust mites sensitization, bronchial hyperresponsiveness and pulmonary function are still controversial. METHODS:One hundred eighteen children aged 5-12 years with mild to moderate asthma were enrolled. Each subject underwent the pulmonary function test, the methacholine challenge test, and the skin prick test with aeroallergens, and total serum immunoglobin (Ig)E levels. The non-sensitization group was defined when skin prick test results are all negative for common aeroallergens. The sensitization group was defined when skin test results are positive for Dermatophagoides pteronyssinus or Dermatophagoides farinae. RESULTS:In the house dust mites sensitization group, increased serum total IgE and decreased methacholine PC(20) were noted. There was no significant difference in pulmonary functions between sensitization and non-sensitization groups. In the sensitization group, methacholine PC(20) correlated with prebronchodilator %FEF(25-75%) (r=0.346, P=0.008) but did not correlate with %FVC, %FEV(1) and FEV(1)/FVC. In the sensitization group, methacholine PC(20) and pulmonary function did not correlate with total IgE or age. CONCLUSION:The house dust mites sensitization in asthmatic children correlated with increased bronchial responsiveness but did not correlate with decreased pulmonary functions. These findings support the role of house dust mite sensitization in the modulation bronchial responsiveness.
Asthma ; Bronchial Hyperreactivity ; Child* ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Dust* ; Humans ; Immunoglobulin E ; Korea ; Lung* ; Methacholine Chloride ; Pyroglyphidae* ; Respiratory Function Tests ; Risk Factors ; Skin ; Skin Tests

Isolated ACTH deficiency is a uncommon disorder causing secondary adrenocortical insufficiency. Less than 200 cases have been reported in the world. The major clinical manifestations are hypoglycemia, weight loss, hypotension, anemia, weakness, nausea, inability to excrete water load, and hyponatremia. A 56-year-old male was admitted because of weakness, fatigue, nausea and vomiting. He was pallor and not associated with hyperpigmentation. The basal plasma ACTH and cortisol levels were 8.30 pg/ml and 0.6 ug/dl. The serum cortisol did not response to rapid ACTH stimulation test. On combined pituitary stimulation test, the cortisol did not response to insulin-induced hypoglycemia. Other anterior pituitary hormones showed normal responses except elevated prolactin level. Six months after glucocorticoid replacement therapy, the elevated basal prolactin level returned to normal. Brain MRI did not show any anatomic abnormalities of the sellar and suprasella area. We report a case of isolated ACTH deficiency accompanied by hyperprolactineia, which respond to glucocorticoid replacement therapy.
Adrenal Insufficiency ; Adrenocorticotropic Hormone* ; Anemia ; Brain ; Fatigue ; Humans ; Hydrocortisone ; Hyperpigmentation ; Hyperprolactinemia* ; Hypoglycemia ; Hyponatremia ; Hypotension ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nausea ; Pallor ; Pituitary Hormones, Anterior ; Plasma ; Prolactin ; Vomiting ; Water ; Weight Loss

OBJECTIVES: Methylenetetrahydrofolate reductase (MTHFR) mutation are commonly associated with hyperhomocysteinemia, and through their defects in homocysteine metabolism, they have been implicated as a risk factor for recurrent spontaneous abortion. Recent report describe that 28-bp tandem repeat polymorphism in thymidylate synthase enhancer region (TSER) that influence enzyme activity would affect plasma homocysteine level. We have investigated the relationship between TSER genotype and plasma homocysteine level in 54 patients with recurrent spontaneous abortion. METHODS: Plasma homocysteine level was measured by fluorescent polarizing immunoassay. MTHFR mutation (C677T and A1298C) was identified by PCR-restriction fragment length polymorphism assay and TSER mutation was analyzed by PCR method. The data were analyzed using the program SAS 8.2 for Windows. RESULTS: Total homocysteine level was significantly higher in MTHFR 677TT genotype (9.80+/-3.87 mumol/L) than MTHFR 677CC genotype (8.14+/-1.74 mumol/L) in Korean patients with unexplained recurrent spontaneous abortion (p=0.0143). However, the plasma homocysteine level was not significantly different in the MTHFR 1298AA (8.42+/-2.65 mumol/L) and 1298CC (6.09+/-0.32 mumol/L; p=0.2058) and, TSER 2R2R (8.61+/-1.68 mumol/L) and 3R3R (8.05+/-2.81 mumol/L; p=0.9319) mutant genotypes, respectively. In this study, we found the combination effects of TSER and MTHFR C677T genotypes. Plasma homocysteine levels were the highest (11.47+/-4.66 mumol/L) in individuals with TSER 3R3R (8.05+/-2.81 mumol/L) and MTHFR 677TT (9.80+/-3.87 mumol/L) genotypes. Individuals with a combination of both TSER 2R2R/2R3R and MTHFR 677CC/CT genotypes (7.69+/-1.77 mumol/L) had lower plasma homocysteine levels than TSER 2R2R (8.61+/-1.68 mumol/L) and MTHR 677CC (8.14+/-1.74 mumol/L) genotypes, respectively. The effect of MTHFR polymorphism in the homocysteine metabolism appears to be stronger than that of TSER polymorphism. CONCLUSION: Although statistically not significant, we found the elevated level of plasma homocysteine in combined genotypes with TSER and MTHFR (C677T and A1298C) in Korean patients with unexplained habitual abortion. In this study, we reported the possibility that TSER polymorphism is a genetic determinant of plasma homocysteine levels in the Korean patients as well as MTHFR C677T polymorphism. A large prospective study is needed to verify our findings.
Abortion, Habitual ; Abortion, Spontaneous* ; Female ; Genotype ; Homocysteine* ; Humans ; Hyperhomocysteinemia ; Immunoassay ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2) ; Plasma* ; Polymerase Chain Reaction ; Pregnancy ; Risk Factors ; Tandem Repeat Sequences ; Thymidylate Synthase*

Neurofibromatosis type 1 (NF-1) is a genetically inherited disorder that may cause skin abnormalities and tumors that form on nerve tissues. These tumors can be small or large and can occur anywhere in the body, including the brain, spinal cord, or other peripheral nerves. Retroperitoneal lymphangiomas are very rare benign malformations of the lymphatic system. About 95% lymphangiomas occur in the skin and the subcutaneous tissues of the head, neck and axillary region and the remaining 5% appear in other parts of the body such as lungs, pleura, pericardium, liver, gallbladder, kidney, and the mesentery. Herein, we report the case of a giant retroperitoneal lymphangioma in a patient with NF-1 with a review of the literature.
Brain ; Gallbladder ; Head ; Humans ; Kidney ; Liver ; Lung ; Lymphangioma ; Lymphatic System ; Mesentery ; Neck ; Nerve Tissue ; Neurofibromatoses ; Neurofibromatosis 1 ; Pericardium ; Peripheral Nerves ; Pleura ; Retroperitoneal Neoplasms ; Skin ; Skin Abnormalities ; Spinal Cord ; Subcutaneous Tissue

No abstract available.
Heart Septal Defects, Atrial*

Rifampin is sometimes associated with hematologic complications such as hemolytic anemia or thrombocytopenia. Patients with drug-induced thrombocytopenia develop a drug- dependent antibody that binds to platelets in the presence of the drug causing platelet clearance. It has been previously proposed that the antibody binds the drug, resulting in an immune complex that is then adsorbed onto platelets. However, it has been recently known that drug-dependent antibodies bind to one or more of the platelet membrane glycoprotein Ib, IIb, IIIa, and IX. We, hereby, report a case of rifampin-induced thrombocytopenia in which drug-dependent antibody specific for platelet glycoprotein Ib/IX and IIb/IIIa was demonstrated by modified antigen capture ELISA method. The case was a 37 year-old female who had had pulmonary tuberculosis and taken antituberculous regimen including rifampin. Intermittent epistaxis appeared 10 days after treatment with rifampin. She was admitted to hospital due to gingival bleeding for 3 days and menorrhagia for 2 days. On admission, her platelet count was dropped to 7,000/microliter.
Adult ; Anemia, Hemolytic ; Antibodies* ; Antigen-Antibody Complex ; Blood Platelets* ; Enzyme-Linked Immunosorbent Assay ; Epistaxis ; Female ; Glycoproteins* ; Hemorrhage ; Humans ; Menorrhagia ; Platelet Count ; Platelet Glycoprotein GPIb-IX Complex ; Rifampin ; Thrombocytopenia* ; Tuberculosis, Pulmonary