No abstract available.
Plasma Exchange* ; Plasma*

Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PD^. We encountered three cases of isolated unilateral absence of a pulmonary artery;one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateal lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of aquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluaton of the unilateral absence of a pulmonary artery.
Adipose Tissue ; Aorta, Thoracic ; Heart Defects, Congenital ; Lung ; Pulmonary Artery* ; Pulmonary Embolism ; Radiography, Thoracic ; Tomography, X-Ray Computed

BACKGROUND: Lung cancer is one of the leading causes of cancer-related deaths throughout the world. The gene tumor protein 53 (TP53) is frequently mutated in cases of lung cancer. This study was performed to investigate the frequencies and types of mutations in the TP53 gene in Korean patients with lung cancer. METHODS: We obtained tissue samples from 80 lung cancer patients and synthesized TP53 cDNA by using RNA isolated from these tissues by performing reverse transcriptase polymerase chain reaction. Hybridization and denaturing high-performance liquid chromatography were performed to identify the TP53 gene mutations, and then, the mutations were validated by direct sequencing. RESULTS: Forty mutations out of the 80 patients (50.0%) were noted in the TP53 gene. The frequencies of TP53 gene mutation for different cancer types, namely, squamous cell carcinoma, adenocarcinoma, and small cell carcinoma were 61.1%, 27.3%, and 26.7%, respectively. The mutation frequencies in the different regions of the gene were 10.0% for exon 4, 35.0% for exon 5, 12.5% for exon 6, 22.5% for exon 7, 17.5% for exon 8, and 2.5% for exon 9. The frequently mutated positions were codon 179 in exon 5, codons 202 and 220 in exon 6, and codons 266 and 273 in exon 8. CONCLUSIONS: Exon 5 was the most frequently mutated region in the TP53 gene. Compared to the patients with the other types of cancers, patients with squamous cell carcinoma showed a higher frequency of TP53 mutation. Codon 179 was the most frequently mutated codon in the TP53 gene.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chimera ; Chromatography, Liquid ; Codon ; DNA, Complementary ; Exons ; Genes, p53 ; Humans ; Lung ; Lung Neoplasms ; Mutation Rate ; Reverse Transcriptase Polymerase Chain Reaction ; RNA

The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5∼6 to 0∼1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.

The incidence of heterotopic ossification (HO) was reported to be higher in combat-injured patients than in civilian trauma patients. HO is often considered a possible cause of residual limbs pain in amputee. Here, we report the case of a 21-year-old male, who underwent a traumatic right transfemoral and left transtibial amputation with two segments of painful HO around his left amputation site. We report the effect of extracorporeal shock wave therapy (ESWT) on size and pain associated with HO. After ESWT, the visual analog scale score decreased from 5∼6 to 0∼1 and the size of two masses decreased from 13.1 × 6.7 mm and 12.5 mm to 11.9 × 4.7 mm and 12.2 mm, respectively. To the best of our knowledge, this is the first case that has reported on the treatment of HO using ESWT for a traumatic transtibial amputation patient. The case suggests that ESWT could serve as a complementary treatment for HO in traumatic amputation patient.

Background: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. Case: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1–2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. Conclusions It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.

Gitelman's sydnrome is a heritable renal disorder characterized by hypomagnesemia, hypokalemia and hypocalciuria. As compared to those with Bartter's syndrome, reduced urinary excretion of calcium and magesium wasting are essential features of Gitelman's syndrome. Interestingly, we have experienced a case of 32-year old man with a mixed type of Gitelman's syndrome and Bartter's syndrome, which includes normomagnesemia, normal renal magnesium excretion, and hypocalciuria. Herein we report the case of atypical Gitelman's syndrome with brief review of related literature.
Adult ; Bartter Syndrome ; Calcium ; Gitelman Syndrome* ; Humans ; Hypokalemia ; Magnesium*

The authors present a very rare case of an intrasellar cavernous hemangioma that mimick a pituitary macroadenoma radiologically. A 63-year-old male patient was admitted with visual field defect and clinical manifestations of pituitary failure. MR image revealed intrasellar gadolinium-enhancing tumor with parasellar extension suggesting pituitary macroadenoma. But pathology was cavernous hemangioma. It was suggested that cavernous hemangioma should be included in the differential diagnosis of pituitary mass.
Diagnosis, Differential ; Hemangioma, Cavernous* ; Humans ; Male ; Middle Aged ; Pathology ; Pituitary Neoplasms ; Sella Turcica ; Visual Fields

In 2016, external quality assessment trials for urinalysis and faecal occult blood (FOB) were performed with 1,487 participants in Korea. Urine chemistry and FOB tests were performed three and two times, respectively, whereas urine sediment was evaluated once using photography. Urine chemistry tests consisted of pH, protein, glucose, ketone, bilirubin, blood, urobilinogen, and nitrite levels; leukocyte count; specific gravity. The results of the urine chemistry and specific gravity tests showed accuracy rates of >95%. The accuracy rate of urine sediments was low, especially that for transitional epithelial cells and atypical crystals. In the FOB quality test, all reagents showed accuracy rates of >90%, which suggested the improvement of false-positive reaction. In the FOB quantitative test, discrepant results depending on the instrument used was observed. To compensate for the result differences caused by the stool samples, the results should be reported using another unit (µg/g of stool).
Bilirubin ; Chemistry ; Epithelial Cells ; Glucose ; Hydrogen-Ion Concentration ; Indicators and Reagents ; Korea* ; Leukocyte Count ; Occult Blood* ; Photography ; Specific Gravity ; Urinalysis* ; Urobilinogen

Langerhans cell sarcoma (LCS) is a neoplastic proliferation of Langerhans cells that have overtly malignant cytologic features. It is a very rare disease and theoretically, it can present de novo or progress from an antecedent Langerhans cell histiocytosis (LCH). However, to our knowledge, LCS arising from an antecedent LCH has not been reported on. We present here a case of LCS arising from a pulmonary LCH. A 34 yr-old man who was a smoker, had a fever and a chronic cough. Computed tomographic (CT) scan revealed multiple tiny nodules in both lungs. The thoracoscopic lung biopsy revealed LCH. The patient quit smoking, but he received no other specific treatment. One year later, the follow up chest CT scan showed a 4 cm-sized mass in the left lower lobe of the lung. A lobectomy was then performed. Microscopic examination of the mass revealed an infiltrative proliferation of large cells that had malignant cytologic features. Immunohistochemical stains showed a strong reactivity for S-100 and CD68, and a focal reactivity for CD1a. We think this is the first case of LCS arising from LCH.
Tomography, X-Ray Computed ; Sarcoma/*pathology ; S100 Proteins/biosynthesis ; Radiography, Thoracic ; Pancreatic Neoplasms/*pathology ; Male ; Langerhans Cells/*pathology ; Immunohistochemistry ; Humans ; Histiocytosis, Langerhans-Cell/diagnosis/*pathology ; Gene Expression Regulation, Neoplastic ; Antigens, Differentiation, Myelomonocytic/biosynthesis ; Antigens, CD1/biosynthesis ; Antigens, CD/biosynthesis ; Adult