Solitary plasmacytoma, in contrast to the disseminated neoplastic proliferation of plasma cells with marked infiltration of multiple organ system in multiple myeloma, is plasma cell neoplasm of a single focus occuring either in bone or soft tissue. The association between a solitary plasmacytoma and peripheral neuropathy is rare, and it is a progressive sensorimotorneuropathy, with a raised CSF protein and mixed demyelination and axonal loss in nerve biopsy. Localized radiotherapy indeed proves to be effective of not only arresting the progress of the neuropathy but also allowing a degree of recovery. We experienced a 55-year-old male with a solitary plasmacytoma and peripheral neuropathy confirmed by the radiologic studies, immunohistochemical stain of nasopharyngeal mucosa biopsy and sural nerve biopsy, which has loss of myelinated fiber and axonal degeneration. Until now, the reported cases are very rare in Korea, so we presented a case of solitary plasmacytoma associated with peripheral neuropathy.
Axons ; Biopsy ; Demyelinating Diseases ; Humans ; Korea ; Male ; Middle Aged ; Mucous Membrane ; Multiple Myeloma ; Myelin Sheath ; Neoplasms, Plasma Cell ; Peripheral Nervous System Diseases* ; Plasma Cells ; Plasmacytoma* ; Radiotherapy ; Sural Nerve

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.
Adenoma, Pleomorphic ; Aged ; Cytosine ; Female ; Giant Cell Tumors ; Giant Cells ; Humans ; Korea ; Mixed Tumor, Malignant ; Monocytes ; Osteoclasts ; Parotid Gland ; Salivary Glands ; Stromal Cells

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.
Adenoma, Pleomorphic ; Aged ; Cytosine ; Female ; Giant Cell Tumors ; Giant Cells ; Humans ; Korea ; Mixed Tumor, Malignant ; Monocytes ; Osteoclasts ; Parotid Gland ; Salivary Glands ; Stromal Cells

OBJECTIVE: To evaluate the effect of a gonadotropin-releasing hormone (GnRH) antagonist protocol using corifollitropin alfa in women undergoing assisted reproduction. METHODS: Six hundred and eighty-six in vitro fertilization-embryo transfer (IVF)/intracytoplasmic sperm injection (ICSI) cycles were analyzed. In 113 cycles, folliculogenesis was induced with corifollitropin alfa and recombinant follicle stimulating hormone (rFSH), and premature luteinizing hormone (LH) surges were prevented with a GnRH antagonist. In the control group (573 cycles), premature LH surges were prevented with GnRH agonist injection from the midluteal phase of the preceding cycle, and ovarian stimulation was started with rFSH. The treatment duration, quality of oocytes and embryos, number of embryo transfer (ET) cancelled cycles, risk of ovarian hyperstimulation syndrome (OHSS), and the chemical pregnancy rate were evaluated in the two ovarian stimulation protocols. RESULTS: There were no significant differences in age and infertility factors between treatment groups. The treatment duration was shorter in the corifollitropin alfa group than in the control group. Although not statistically significant, the mean numbers of matured (86.8% vs. 85.1%) and fertilized oocytes (84.2% vs. 83.1%), good embryos (62.4% vs. 60.3%), and chemical pregnancy rates (47.2% vs. 46.8%) were slightly higher in the corifollitropin alfa group than in the control group. In contrast, rates of ET cancelled cycles and the OHSS risk were slightly lower in the corifollitropin alfa group (6.2% and 2.7%) than in the control group (8.2% and 3.5%), although these differences were also not statistically significant. CONCLUSION: Although no significant differences were observed, the use of corifollitropin alfa seems to offer some advantages to patients because of its short treatment duration, safety, lower ET cancellation rate and reduced risk of OHSS.
Embryo Transfer ; Embryonic Structures ; Female ; Follicle Stimulating Hormone* ; Gonadotropin-Releasing Hormone* ; Humans ; Infertility ; Luteinizing Hormone ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovulation Induction ; Pregnancy Rate ; Reproduction* ; Spermatozoa

Actinomycosis still poses a problem for correct clinical and radiologic diagnosis. We retrospectively analyzed CT findings in 7 patients with pathologically proven abdominal actinomycosis. Involved areas were the pelvis (n=3), greater omentum (n=2), liver (n=1), and kidney (n=1). CT confirmed the infiltrative nature of the disease with a tendency to invade across tissue plane and boundary. Five of seven cases were predominantly solid mass (pseudotumor) with focal low-attenuation areas while two were predominantly cystic mass with thickened wall. Contrast-enhanced CT showed dense, inhomogeneous contrast enhancement in the wall and/ or solid components of the masses in five. Minimal lymphadenopathy was noted in one case. CT is useful in demonstrating the extent and characteristics of this disease. Despite nonspecific findings, actinomycosis should be included in the differential consideration when CT shows an infiltrative mass with unusual aggressiveness and dense inhomogeneous contrast enhancement in patients with fever, leukocytosis, or long-term use of intrauterine contraceptive devices.
Actinomycosis* ; Diagnosis ; Fever ; Humans ; Intrauterine Devices ; Kidney ; Leukocytosis ; Liver ; Lymphatic Diseases ; Omentum ; Pelvis ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Occupational Health*

We report two cases of porphyric peripheral neuropathy in a 19-year-old male with variegate porphyria and in a 39 year-old male with intermittent acute prophyria. Clinically, there were sensory, motor disturbance and autonomic symptoms including decreased sweating, urinary and sphinctor distrubances. Variegate porphyria showed facial diplegia and positive family history inherited by autosomal dominent trait. Intermittent acute porphyria was combined-with SIADH. Both cases were expired due to respiratory failure. Nerve conduction studies were carried out in two cases and both cases showed slow motor, sensory nerve conductlon velocity ,and significant low CMAPs(Compound Muscle Action Potentials). Sural nerve biopsy was carried out in a variegate prophyria compared with one normal control. Decreased large myelinated fibers was found. In nerve fiber teased study. 8.5% of nerve fibers showed axonal degenration and only 2.3% of the segmental demyelination. There findings are suggesting that the porphyric neuro might be the axonal type.and severe neuropathy in a sign of poor prognosis.
Adult ; Axons ; Biopsy ; Demyelinating Diseases ; Humans ; Inappropriate ADH Syndrome ; Male ; Myelin Sheath ; Nerve Fibers ; Neural Conduction ; Peripheral Nervous System Diseases ; Porphyria, Acute Intermittent ; Porphyria, Variegate ; Prognosis ; Respiratory Insufficiency ; Sural Nerve ; Sweat ; Sweating ; Young Adult

No abstract available.
Gwangju* ; Humans ; Pediatric Obesity*

No abstract available.
Pregnancy*

Endomyocardial biopsy (EMB) is a valuable diagnostic procedure for the surveillance of cardiac allograft rejection. Interpretation of individual cases is still problematic due to variations of findings for grading of rejection and other associated lesions. We reevaluated an experience on endomyocardial biopsies to develop better diagnostic criteria for rejection and other complications. Immunohistochemical studies against cytokines were performed to assess the usefulness of the method for the diagnosis or researches. A total of 249 EMBs taken from 33 cardiac allograft recipients were reviewed. There were 25 males and 8 females. Dilated cardiomyopathy was present (24 cases) and valvular heart disease (4 cases), restrictive cardiomyopathy (3 cases) were also common conditions. We applied the grading system of the International Society for Heart Transplantation (ISHT) for the assessment of acute cellular rejection. Grades of 0, 1A, 1B, 2, 3A and 3B were 39.0%, 28.1%, 11.2%, 11.5%, 12.4% and 1.6% respectively, but 3.2% were inadequate. Thirty five episodes of grade 3A or 3B were present in 17 patients. The response to therapy was assessed using a next follow up biopsy, which revealed resolving or resolved rejection in 85% of patients. The intensity of immunohistochemical stains for IL-6 and TNF-alpha was increased in proportion to the histologic grade but Quilty lesion and cardiomyopathy also showed a positive reaction. The other pathologic findings were ischemic change, previous biopsy site, interstitial edema and fibrosis, and Quilty lesion. These findings showed usefulness of endomyocardial biopsy not only for the evaluation of cardiac allograft rejection but also for the diagnosis of associated cardiac lesions. Immunohistochemical study of the cytokines was related to the degree of inflammation rather than degree of rejection.
Allografts ; Biopsy* ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Restrictive ; Coloring Agents ; Cytokines ; Diagnosis ; Edema ; Female ; Fibrosis ; Follow-Up Studies ; Heart Transplantation* ; Heart Valve Diseases ; Heart* ; Humans ; Inflammation ; Interleukin-6 ; Male ; Tumor Necrosis Factor-alpha