We report a case of angiosarcoma of the jejunum in a 65-year-old female. This angiosarcoma developed 20 years after postoperative irradiation for cervical carcinoma of the uterus. Grossly, the resected jejunum showed a 8 cm long segmental hemorrhagic lesion with multiple, small hemorrhagic nodules or cysts on its serosa and mesentery. Microscopically, the wall of jejunum was infiltrated by epithelioid or polygonal tumor cells arranged in solid nests or lining irregular vascular spaces. The case is of interest that the tumor occurred in the very unusal site for angiosarcoma and the patient had a past history of irradiation for uterine cervical carcinoma 20 years ago. In addition, the resected intestine showed histologic changes of chronic irradiation effect. Therefore, this case supports the view that there is cause and effect relationship between irradiation adn angiosarcoma.
Female ; Humans ; Cysts

BACKGROUND: Nosocomial urinary tract infection (UTI) accounts for 35% of the nosocomial infection and 80-90% of them are associated with urethral catheters. Recently, we experienced an outbreak of nosocomial UTI caused by multidrug-resistant Pseudomonas aeruginosa in neurosurgical intensive care unit (NSICU). METHODS: We investigated clinical records of the patients and observed the methods of care of urethral catheters in NSICU. Identification of P. aeruginose was done by API NE (API system; bioMerieux, France) and antibiotic susceptibility tests were done by disk diffusion method. Random Amplification of Polymorphic DNA (RAPD) assay was used as a genotyping method. RESULTS: Between November 1997 and January 1998, 11 P. aeruginosa strains were isolated from the urine of 11 patients hospitalized in NSICU of Kangnam St. Mary's Hospital. Routine regular bladder irrigation, and emptying urine with common urinal had been done falsely. Antibiogram of the isolates showed resistance to multiple antibiotics including imipenem, gentamicin. amikacin, piperacillin, ciprofloxacin, ceftazidime, and cefoperazone/sulbactam. RAPD of the outbreak strains showed clonal relatedness, which was different from those of other clinical strains, We instructed all the health care workers to stop bladder Irrigation, and to use the separate urinals for each patient. Thereafter, no further case of P. aeruginosa UTI has occurred. CONCLUSION: An outbreak of UTI, caused by a single clone of P. aeruginosa, was confirmed by RAPD and was eradicated after correction of false practice on care-of urinary catheter.
Amikacin ; Anti-Bacterial Agents ; Ceftazidime ; Ciprofloxacin ; Clone Cells ; Cross Infection ; Delivery of Health Care ; Diffusion ; DNA ; Drug Resistance, Multiple ; Gentamicins ; Humans ; Imipenem ; Intensive Care Units ; Microbial Sensitivity Tests ; Piperacillin ; Pseudomonas aeruginosa* ; Pseudomonas* ; Urinary Bladder ; Urinary Catheters ; Urinary Tract Infections* ; Urinary Tract*

PURPOSE: To compare intraocular straylight in normal and cataractous eyes as the morphology and to compare straylight as the result of subjective symptoms in early cataract cases using the C-quant straylight meter, the only tool to measure light scattering in media. METHODS: Straylight values were measured in 217 normal eyes and 138 cataractous eyes. Cataractous eyes were classified into posterior subcapsular opacity, anterior subcapsular opacity and nucleosclerosis. Straylight values of each group were measured. The 56 early cataractous eyes were categorized into two groups, depending on the presence of subjective symptoms, and each straylight value was measured. The preoperative and postoperative straylight values of early cataracts were also compared. RESULTS: The mean straylight values of normal and cataractous eyes were 1.34 and 2.46, respectively. The value of posterior subcapsular opacity (2.81) was significantly higher than that of anterior subcapsular opacity (2.33) and nucleosclerosis (1.99). The straylight values of early cataracts were significantly higher in the group with subjective symptoms (2.02) than in the group without subjective symptoms (1.56). The postoperative straylight value decreased to 1.42. CONCLUSIONS: The posterior subcapsular cataract showed significantly high intraocular straylight, indicating that light scattering occurred to a greater extent in this group. Light scattering occurred more in early cataractous eyes with subjective symptoms than in eyes without symptoms, and light scattering was reduced after surgery. The C-quant straylight meter, which measures the light scattering in media, can be a useful tool to determine the time of cataract surgery and to evaluate the quality of vision.
Cataract ; Eye ; Light ; Vision, Ocular

Well differentiated osteosarcomas are variants of osteosarcoma composed mainly of fibrous and osseous tissue with minimal cystologic atypia. This tumor may be misinterpretated as a benign lesion if the radiologic and clinical features are not taken into account. We report a typical case of intraosseous well differentiated osteosarcoma occuring in the left distal femur of a 58-year-old woman. Radiologically, it appered as an ill-defined lesion with a mixture of sclerotic and osteolytic ares. But there was a lack of highly destructive appearance of conventional osteosarcoma. Grossly, the mass occupied a metaphysis of the distal femur with extension into the diaphysis and epiphysis. Multifocal cortical destruction and sclerosis were also associated. Histologically, the mass showed typical features of intraosseous well differentiated osteosarcoma. There were various patterns of osteoid deposits and bone formation mimicking those of fibrous dysplasia, nonossifying fibroma or parosteal osteosarcoma.
Female ; Humans

No abstract available.
Gastric Emptying*

OBJECTIVES: To investigate the relationship of serum uric acid to cardiovascular risk factors in Korean male workers. METHODS: We screened 522 male workers at an electrical manufacturing company by a periodic health examination and a questionnaire survey in 2000. We collected data relating to age, smoking status, alcohol drinking status, body mass index (BMI), blood pressure, serum lipid, fasting blood glucose and serum uric acid. The data were analyzed using a variety of methods, including ANOVA, Pearson's correlation, and multivariate regression analyses, to examine the association between uric acid and cardiovascular risk factors with a cross-sectional study design. RESULTS: The concentration of serum uric acid showed positive associations with BMI, total cholesterol, triglyceride, and LDL-cholesterol; it was also significantly correlated to systolic and diastolic blood pressures. Life-style characteristics, such as smoking and alcohol drinking showed no significant association. From the multivariate regression analyses, BMI, total cholesterol and fasting blood glucose levels were found to be independent positive predictors of uric acid; while age, blood pressure and smoking status give no independent contribution explaining the variability of serum uric acid levels. Conclusions : This study demonstrates that serum uric acid level have a significant association with cardiovascular risk factors, such as BMI, total cholesterol and blood glucose in some Korean male workers.
Alcohol Drinking ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cholesterol ; Cross-Sectional Studies ; Fasting ; Humans ; Male* ; Surveys and Questionnaires ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Uric Acid*

Glanzmann's thrombasthenia (GT) is a rare inherited platelet disorder, which is characterized by a complete lack of platelet aggregation due to a deficiency or abnormality of the membrane glycoprotein IIb/IIIa complex. Anti-GPIIb/IIIa antibodies have also been identified to cause platelet dysfunction in patients with a normal platelet count, but this has only been rarely encountered. The condition is also known as acquired GT. Herein, we describe a patient with acquired GT and a history of Evans' syndrome, who presented with severe bleeding and platelet dysfunction, but with a normal platelet count and GP IIb/IIIa expression.
Antibodies ; Blood Platelets ; Hemorrhage ; Humans ; Membrane Glycoproteins ; Platelet Aggregation ; Platelet Count ; Thrombasthenia*

Mantle cell lymphoma is a subtype of aggressive non-Hodgkin's lymphoma and usually presents in advanced stages. When treated with a regimen such as CHOP, the median survival is about three years. More aggressive front-line therapy with the hyper-CVAD regimen or high-dose therapy with stem cell support has shown encouraging results in several trials. The addition of rituximab to the chemotherapy regimens, or high-dose therapy, increased the response and survival rates in patients with mantle cell lymphoma. We report a case of mantle cell lymphoma that was successfully treated with aggressive front-line treatment strategies. The patient achieved complete remission with initial hyper-CVAD regimen, and was consolidated with autologous stem cell transplantation and subsequent rituximab.
Drug Therapy ; Humans ; Lymphoma, Mantle-Cell* ; Lymphoma, Non-Hodgkin ; Stem Cell Transplantation* ; Stem Cells* ; Survival Rate ; Rituximab

In recent years, the incidence of adenocarcinoma of the esophagogastric junction (AEJ) is increasing in the western world, despite of decreasing trend of distal gastric cancer, and the prognosis of AEJ remains poor. The appropriate classification of AEJ is important for selecting the optimal surgical approach and making better prognosis. According to Siewert's classification, distal esophageal cancers (type I) are distinguished from true cardia cancers (type II) and subcardiac gastric cancers (type III). Until now, surgical resection with lymphadenectomy based on Siewert's classification has been the mainstay of treatment for all resectable AEJ. Except surgical approach, therapy strategies for AEJ include endoscopic ablation or endoscopic mucosal resection, endoscopic submucosal dissection, neoadjuvant or adjuvant therapy in combination with surgery, and palliative procedures such as stent, laser, photodynamic therapy. A multidisciplinary approach is necessary for optimal management of AEJ. In this article, we review the treatment options for AEJ including a tailored surgical approach.
Adenocarcinoma ; Cardia ; Esophageal Neoplasms ; Esophagogastric Junction ; Incidence ; Lymph Node Excision ; Photochemotherapy ; Prognosis ; Stents ; Stomach Neoplasms ; Western World

PURPOSE: Perinatal asphyxia is an important cause of neurologic morbidity. Experiments in animal models of hypoxic-ischemic brain injury demonstrate that brain damage starts during hypoxia-ischemia. In order to evaluate the ischemic condition-induced neurotoxic effect in view of oxi-dative stress, we examined the cytotoxic effect in cultured cerebral neurons of neonatal mouse. METHODS: Dissociated cell cultures were prepared from cerebrum of neonatal mouse. Tissues were diced into small pieces and were incubated in phosphate buffered saline at 37degrees C. Isolated cells were resuspended in the medium and plated in poly-L-lysine coated 96 well multichambers at a cell density of 5x104cells/well. Cells were grown in a 5% CO2/95% air atmosphere at 37degrees C. Cytotoxic effects were examined in the cultured cerebral neurons with time interval in the ischemic condition with a 95% nitrogen/5% CO2. And the protective effect of vitamin E and desferrioxamine as an antioxidant was examined by MTT assay and neurofilament enzymeimmunoassay(EIA). Microscopic examinations were also done. RESULTS: Ischemic condition markedly decreased the cell viability in a time-dependent manner in cultured cerebral neurons. MTT50 value was estimated at 10 minutes, when cerebral neurons were incubated for various time intervals in ischemic condition. Under light microscopy, the number of cells and neurites were decreased when cerebral neurons were cultured for 10 minutes in the ischemic condition. Vitamin E was an effective antioxidant in blocking ischemic condition-induced neurotoxicity, while desferrioxamine was not in these cultures. CONCLUSION: It is suggested that ischemic conditions are neurotoxic and selective antioxidant such as vitamin E is effective in protecting against the neurotoxicity induced by ischemic condition in cultured cerebral neurons of neonatal mouse.
Animals ; Anoxia ; Asphyxia ; Atmosphere ; Brain ; Brain Injuries ; Cell Count ; Cell Culture Techniques ; Cell Survival ; Cerebrum ; Deferoxamine* ; Ischemia ; Mice* ; Microscopy ; Models, Animal ; Neurites ; Neurons* ; Oxidative Stress ; Vitamin E* ; Vitamins*