Primary cutaneous CD30+ large cell lymphoma(LCL) is a rare cutaneous peripheral T cell lymphoma with a favorable prognosis. This lymphoma characteristically presents itself as a solitary or localized skin tumor with frequent cutaneous relapses and partial or complete spontaneous remission. Recently we saw a sixty-three year old male who had developed primary cutaneous CD30+ large cell lymphoma that waxed and waned. He presented with localized multiple nodules that had shown repetitive spontaneous regression and recurrences with the same morphology in the same area for several years. There was no evidence of nodal and visceral involvement. The immunohistochemical studies demonstrated that most neoplastic cells in the tumor were positive for CD30 and pan-T cells and negative for pan-B cells, S-100 proteins, EMA and monocyte-macrophage related antigen(CD68).
Humans ; Lymphoma* ; Lymphoma, T-Cell, Peripheral ; Male ; Prognosis ; Recurrence* ; Remission, Spontaneous ; S100 Proteins ; Skin

PURPOSE: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. METHODS: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. RESULTS: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). CONCLUSION: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.
Cause of Death ; Humans ; Injury Severity Score ; Korea ; Medical Records ; Mortality ; ROC Curve ; Sensitivity and Specificity ; Thoracic Injuries* ; Thorax* ; Triage

BACKGROUND: Sevoflurane, a newly developed halogenated inhalation anesthetic agent shows myocardial protective effects against global ischemia like other inhalation agents. We investigated differences between pharmacologic preconditioning effects at various concentrations of sevoflurane. METHODS: Forty male Sprague-Dawley rats were subdivided into 4 groups (each n = 10). All groups underwent the same procedure (Langendorff preparation, 30 minutes ischemia and 60 minutes reperfusion) except for the concentrations of sevoflurane. The control group received no sevoflurane treatment. The sevo 1.6% group was given 1.6% sevoflurane before ischemia, the sevo 205% group was given 2.05% sevoflurane before ischemia, and the sevo 2.5% group was given 2.5% sevoflurane before ischemia. Hemodynamic parameters of all groups were recorded through a thin, saline-filled latex balloon and a transducer. Coronary flows were also measured. All hearts were stained by triphenyl tetrazolium to measure infarct size. RESULTS: The sevoflurane administered groups showed higher left ventricular end systolic pressures and lower left ventricular end diastolic pressures than the control group after ischemia and reperfusion. The dP/dtMAX of the sevoflurane administration groups showed a more rapid recovery pattern after ischemia than the control. But no differences were found between the sevoflurane administered groups. Infarct sizes in the sevoflurane administered groups were smaller than those in the control group, and there were no significant differences between the sevoflurane administered groups. CONCLUSIONS: Sevoflurane (even below one MAC) administration before myocardial ischemia has a superb cardioprotective effects, i.e., rapid recovery of left ventricular fuctions, less stiffness development, and a reduced infarct size. There were no significant differences between the sevoflurane administered groups.
Animals ; Heart* ; Hemodynamics ; Humans ; Inhalation ; Ischemia* ; Latex ; Male ; Myocardial Ischemia ; Rats* ; Rats, Sprague-Dawley ; Reperfusion ; Transducers ; Ventricular Function, Left

Ectopic pancreas rarely produces clinical symptoms. Most commonly reported symptoms were abdominal pain, epigastric discomfort, nausea, vomiting, and bleeding. However, presentation of specific symptoms due to its size and location, including obstructive jaundice, and pyloric obstruction are possible. Ectopic pancreas is subject to various pathological changes occurring in the pancreas itself; namely, cyst, pancreatitis, hemorrhage, necrosis, and neoplastic change. We present a case of 60-year old woman with right upper quadrant pain in whom the surgical pathologic diagnosis was ectopic pancreas of the stomach complicated by pancreatitis and pseudocyst formation.
Abdominal Pain ; Diagnosis ; Female ; Hemorrhage ; Humans ; Jaundice, Obstructive ; Middle Aged ; Nausea ; Necrosis ; Pancreas* ; Pancreatitis* ; Stomach ; Vomiting

Fiberoptic bronchoscope guided tracheal intubation is more popular in patient with expected difficult intubation by conventional laryngoscopy. We report a case of smooth fiberoptic bronchoscope guided tracheal intubation under local anesthesia. A 10% lidocaine spray 2-3 puffs of pharyngolaryngeal topical anesthesia and 2% lidocaine injection through a 19 gauge epidural catheter (ARROW(R)) placed over the fiberoptic bronchoscope suction channel for laryngeal and tracheal anesthesia were sufficient to prevent pain, coughing and nausea.
Anesthesia* ; Anesthesia, Local ; Bronchoscopes* ; Catheters* ; Cough ; Humans ; Intubation* ; Laryngoscopy ; Larynx* ; Lidocaine ; Nausea ; Suction ; Trachea*

Fiberoptic bronchoscope guided tracheal intubation is more popular in patient with expected difficult intubation by conventional laryngoscopy. We report a case of smooth fiberoptic bronchoscope guided tracheal intubation under local anesthesia. A 10% lidocaine spray 2-3 puffs of pharyngolaryngeal topical anesthesia and 2% lidocaine injection through a 19 gauge epidural catheter (ARROW(R)) placed over the fiberoptic bronchoscope suction channel for laryngeal and tracheal anesthesia were sufficient to prevent pain, coughing and nausea.
Anesthesia* ; Anesthesia, Local ; Bronchoscopes* ; Catheters* ; Cough ; Humans ; Intubation* ; Laryngoscopy ; Larynx* ; Lidocaine ; Nausea ; Suction ; Trachea*

BACKGROUND: Renal dysfunction is a serious complication that sometimes occurs after on-pump coronary artery bypass grafting. Recently, the off-pump coronary artery bypass (OPCAB) is used. We investigated whether this practice can reduce renal compromise. METHODS: Eighty patients underwent CABG surgery between March 2001 and March 2002. Among these, 50 patients received CABG with cardiopulmonary bypass (CPB) and 30 patients received OPCAB. The data collected included age, gender, history of diabetes, history of hypertension, history of congestive heart failuere, preoperative serum creatinine (PreCr) level, peak postoperative serum creatinine (Peak PostCr) level, preoperative and postoperative left ventriclular ejection fraction, preoperative ACE inhibitor use, perioperative angiography with contrast dye. Perioperative changes in creatinine clearance (DCrCl) were calculated using changes in the pre and postoperative serum creatinine values. Moderate postoperative renal dysfuntion was defined as a peak postoperative creatinine value of greater than 1.5 times and below 2.0 times the preoperative creatinine value. Severe postoperative renal dysfunction was defined as a peak postoperative creatinine of more than twice the preoperative creatinine value. RESULTS: Moderate renal dysfunction was observed in 10% of patients in the on-pump group and in 17.6% of the patients in the off-pump group. Severe renal dysfunction was observed in 6.7% of patients in the on-pump group and in 5.9% of the patients in the 0ff-pump group. Multivariate liner regression analysis showed that the preoperative and immediate postoperative creatinine clearance are associated with postoperative renal dysfuntion in both groups. CONCLUSIONS: In this retrospective study, we could not confirm that OPCAB reduces perioperative renal dysfunction more so than CABG with CPB. Diabetes was found to be significantly associated with postoperative renal dysfunction in CABG with CPB.
Angiography ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Creatinine ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Hypertension ; Retrospective Studies

The Asia-Pacific Working Group on inflammatory bowel disease (IBD) was established in Cebu, Philippines, under the auspices of the Asian Pacific Association of Gastroenterology with the goal of improving IBD care in Asia. This consensus is carried out in collaboration with Asian Organization for Crohn's and Colitis. With biologic agents and biosimilars becoming more established, it is necessary to conduct a review on existing literature and establish a consensus on when and how to introduce biologic agents and biosimilars in the conjunction with conventional treatments for ulcerative colitis (UC) and Crohn's disease (CD) in Asia. These statements also address how pharmacogenetics influence the treatments of UC and CD and provide guidance on response monitoring and strategies to restore loss of response. Finally, the review includes statements on how to manage treatment alongside possible hepatitis B and tuberculosis infections, both common in Asia. These statements have been prepared and voted upon by members of IBD workgroup employing the modified Delphi process. These statements do not intend to be all-encompassing and future revisions are likely as new data continue to emerge.
Adalimumab ; Asia ; Asian Continental Ancestry Group ; Biological Factors ; Biosimilar Pharmaceuticals ; Colitis ; Colitis, Ulcerative ; Consensus ; Cooperative Behavior ; Crohn Disease ; Gastroenterology ; Hepatitis B ; Humans ; Immunologic Factors ; Inflammatory Bowel Diseases ; Infliximab ; Pharmacogenetics ; Philippines ; Practice Guidelines as Topic ; Tuberculosis ; Ulcer