Kaposi's sarcoma was the first malignancy to be recognized as a cancer defining acquired immunodeficiency syndrome (AIDS). Kaposi's sarcoma, a rare tumor, usually presents itself with skin lesions but it may be widely disseminated internally such as digestive, respiratory organ, spleen, or lymph node. The incidence of Kaposi's sarcoma in patients with AIDS has declined in the era of effective antiretroviral therapy (ART), and cases of disseminated Kaposi's sarcomas have rarely been reported in Korea. Chemotherapy is usually used in symptomatic or rapidly progressive disease, and interferon-alpha can be applied as a treatment option. We report a successfully treated case of gastrointestinal and cervical lymph nodal Kaposi's sarcoma in a patient with AIDS who had combined treatment with ART, interferon-alpha, and paclitaxel.
Acquired Immunodeficiency Syndrome ; Humans ; Incidence ; Interferon-alpha ; Korea ; Lymph Nodes ; Paclitaxel ; Sarcoma, Kaposi ; Skin ; Spleen

Malignant granular cell tumors (MGST) are extremely rare, high-grade sarcoma of schwann cell origin. They often metastasize and are associated with short survival. We described a patient with recurred MGST after wide marginal excision followed by chemotherapy. The histologic findings revealed relapsed MGST containing rich vascular structure. The patient was treated with sunitinib malate (50 mg/day) for three weeks. Because sunitinib malate has a potent antiangiogenic property, we surmised that it might be effective against this type of malignancy. However, he died due to progression of tumor after six weeks. Here, we report it along with the corresponding literature.
Granular Cell Tumor ; Humans ; Indoles ; Pyrroles ; Sarcoma

Pulmonary sclerosing hemangioma is a relatively rare neoplasm of the lung with polymorphic histologic features of 2 unifying cellular components including surface cuboidal cells and interstitial round cells. Pulmonary sclerosing hemangioma typically occurs in middle aged women with asymptomatic, peripheral, solitary, well-circumscribed lesions. Although it is pathologically benign, it reveals size growing and chest symptom. We here report a case of pulmonary sclerosing hemangioma in a 72-year-old woman. She presented chest discomfort. A chest radiography and a chest computed tomography scan showed growing size from 3.2x3.1 cm to 6.0x5.3 cm in left upper lung during 10 years' follow-up period. Surgical resection of lung revealed a distinct constellation of findings including 2 epithelial cell types, surface cells, and round cells, which form 4 architectural patterns, papillary, sclerotic, solid, and hemorrhagic. She was diagnosed as pulmonary sclerosing hemangioma and chest discomfort disappeared.
Aged ; Epithelial Cells ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Diseases ; Middle Aged ; Pulmonary Sclerosing Hemangioma ; Thorax

Hepatic hydrothorax is defined as the presence of pleural fluid (>500 mL) in the absence of primary cardiac or pulmonary disease. Initial treatments consist of a low salt diet, diuretics, and thoracentesis. If these are not effective, other modalities should be considered. The transjugular intrahepatic portosystemic shunt (TIPS) placement is one of the modalities for treatment of hepatic hydrothorax. However, the effects of TIPS placement have been contradictory. A 42-year-old man was diagnosed hepatic hydrothorax with liver cirrhosis. He was managed with medical therapy, but it was not effective to control hepatic hydrothorax. This case is reported with a review of relevant literature.
Adult ; Carcinoma, Hepatocellular ; Diet ; Diuretics ; Humans ; Hydrothorax ; Liver ; Liver Cirrhosis ; Lung Diseases ; Portasystemic Shunt, Surgical

Radiofrequency ablation (RFA) has been accepted as a safe and effective treatment for unresectable hepatic tumors because of the advantages of a minimally invasive procedure and the local treatment effect. Although RFA can be performed safely in most patients, early and late complications related to mechanical or thermal damage may be observed at follow-up examination. Hemobilia is a very rare complication of RFA and most hemobilia is an immediate complication. However, delayed hemobilia is an even more rare complication after RFA and is known to be a fatal complication. We present a case of delayed fatal hemobilia after RFA for hepatocellular carcinoma.
Carcinoma, Hepatocellular ; Follow-Up Studies ; Hemobilia ; Humans

Aortic intramural hematoma (IMH) is classically defined as a variation of aortic dissection where blood collects within the aortic media without the presence of an intimal flap. Ascending IMH is known to have worse clinical outcomes than IMH of the descending aorta or aortic arch. Therefore, some patients with higher risk of disease progression require surgical corrections. However, the indications and the benefits of surgical management of ascending IMH, compared with medical treatment only, have not yet been established. We present two cases of IMH in the ascending aorta that presented with cardiac tamponade; patients were treated differently according to risk factors.
Aorta ; Aorta, Thoracic ; Cardiac Tamponade ; Disease Progression ; Hematoma ; Humans ; Risk Factors

OBJECTIVE: This hospital has operated the pediatric emergency room from 2011 as being appointed for 'the pediatric emergency room model construction project' by the government. Thus, the author attempted to evaluate the effect of emergency room crowding by comparing the length of stay before and after the introduction of the pediatric emergency room. METHODS: This study compared and analyzed the length of stay according to age, time distribution, injury/non-injury, in-patient/returning home to young patients under 15 years before the operating the pediatric emergency room between January and December 2010 and after the introduction between January and December 2011, respectively. The length of stay of adult patients in the same period was also examined. RESULTS: Despite the increase of pediatric emergency room and in-hospital patients by 63% and 94% after the operation of the pediatric emergency room respectively, the length of stay of the emergency room reduced from 1.8 to 1.4 hours. However, due to the shortage of sick-beds the length of stay of in-hospital patients increased from 3.4 to 4.3 hours. While the hospitalization admission procedure time reduced considerably from 1.8 to 0.9 hours, the time of injured patients had no changes. The number of adult patients and in-hospital patients increased 18%, 8%, respectively, and the length of stay in the emergency room reduced from 2.7 to 2.5 hours. CONCLUSION: Despite increasing the number of pediatric and in-hospital adult patients, the length of stay of the emergency room reduced owing to the operation of the pediatric emergency room which helped to reduce emergency room crowding. However, the ultimate resolution of congestion of the emergency room requires sufficient professional personnel and hospital's policy support to solve a sick-bed shortage problem.
Adult ; Crowding ; Emergencies ; Estrogens, Conjugated (USP) ; Hospitalization ; Humans ; Length of Stay

OBJECTIVE: Many studies have suggested that leptin is a possible cause of atherosclerosis and is proposed as a cardiovascular risk factor in obese patients. Several studies have shown that serum leptin is associated with pulse wave velocity (PWV) and carotid intima-media thickness (IMT). But the relevance of serum leptin levels for predicting incident cardiovascular disease is less clear. In this study, we investigated the relationship between serum leptin levels and aortic PWV, carotid IMT in type 2 diabetes (T2DM) patients. METHODS: Patients with end-stage renal disease or advanced atherosclerosis, systemic infection were excluded. A total of 116 patients (60 male/56 female; age, 59+/-14 years) were included. Serum leptin levels, aortic PWV and carotid IMT were measured. RESULTS: Aortic PWV was significantly associated with age (r=0.28, P<0.005). Carotid IMT was significantly related to age (r=0.46, P<0.001), low density lipoprotein (LDL) cholesterol (r=0.22, P<0.05), lipoprotein (a) (r=0.23, P<0.05) and estimated glomerular filteration rate (r=-0.348, P<0.01). There was no correlation between leptin and aortic PWV or carotid IMT. In multivariate analyses, aortic PWV was associated with age (P=0.007). Carotid IMT was significantly related to age (P<0.001), LDL cholesterol (P=0.01). CONCLUSION: Serum leptin was not associated with aortic PWV or carotid IMT in T2DM patients.
Atherosclerosis ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Cholesterol ; Cholesterol, LDL ; Diabetes Mellitus, Type 2 ; Humans ; Kidney Failure, Chronic ; Leptin ; Lipoprotein(a) ; Lipoproteins ; Multivariate Analysis ; Pulse Wave Analysis ; Risk Factors

OBJECTIVE: Staphylococcal scalded skin syndrome (4S) is not common, but has been increasingly recognized. We investigated the clinical features of 4S for the last 10 years. METHODS: This retrospective study was performed on 68 children who were admitted with 4S during 2001 to 2011. The patients were divided into 3 age groups: <12 months, 12 to 47 months, and > or =48 months. We evaluated the clinical findings and the differences among the 3 age groups. RESULTS: The mean age was 32 months with a peak incidence at age 12 to 47 months. The peak incidence was observed in 2007 with a seasonal occurrence, mainly from July to October. Except 2007, there was no obvious seasonal pattern in incidence. Atopic dermatitis was combined in 10 patients (14.7%). By clinical types, 4 patients (5.9%) were in generalized type, 17 patients (25%) in intermediate type, and 47 patients (69.1%) in abortive type. The patients with generalized type were all neonates, and intermediate type was more frequent in children younger than 12 months. In contrast, abortive type was a most frequent form after 12 months of age. Of 44 patients performed skin culture, methicillin-resistant Staphylococcus aureus was isolated in 25 cases. All affected patients recovered completely with semi-synthetic penicillin or 3rd generation cephalosporins. Four neonates were treated with vancomycin or teicoplanin. CONCLUSION: The peak incidence of 4S was at age 12 to 47 months. The severity of 4S was most severe in children younger than 12 months, showing a difference in clinical types according to the age groups.
Cephalosporins ; Child ; Dermatitis, Atopic ; Humans ; Incidence ; Infant, Newborn ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Retrospective Studies ; Seasons ; Skin ; Staphylococcal Scalded Skin Syndrome ; Staphylococcus aureus ; Vancomycin

OBJECTIVE: Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant morbidity, and for which there is a need for safe and effective alternative therapies. Although a few observations on the efficacy of intravenous immunoglobulin (IVIG) in AD have been reported, clinical evidence of effectiveness from controlled trials is lacking. Therefore, the purpose of this study was to clarify whether IVIG therapy (1.0 g/kg body weight at each monthly visit for 6 months) is effective in childhood atopic dermatitis and to analyze the clinical characteristics of IVIG responses in this disease. METHODS: Forty three atopic dermatitis patients who had characteristic clinical features of atopic dermatitis were included in this study. The patients received an injection of IVIG at 1.0 g/kg body weight at each monthly visit for 6 months. Laboratory tests were performed for blood chemistry, total immunoglobulin E, immunoglobulin G/immunoglobulin A/immunoglobulin M, blood eosinophil count, and C-reactive protein. RESULTS: In total forty three atopic dermatitis patients, only 14 patients completely underwent 6 cycles, but other 29 patients incompletely (1-5 cycles). In the 14 patients, there were just 13 records of scoring atopic dermatitis (SCORAD) index. The mean SCORAD score in the 13 patients was 39.6+/-24.4. SCORAD score decreased significantly (initial SCORAD, 39.6+/-24.4; final SCORAD, 21.3+/-15.6; P=0.016). CONCLUSION: IVIG therapy may be recommended in the treatment of recalcitrant atopic dermatitis. In addition, further investigation on predictive markers for responses of IVIG therapy in atopic dermatitis may be needed.
Body Weight ; Child ; Complementary Therapies ; Dermatitis, Atopic ; Eosinophils ; Humans ; Immunization, Passive ; Immunoglobulin E ; Immunoglobulins ; Immunoglobulins, Intravenous ; Skin Diseases