We evaluated the role of endoseopic balloon dilatation for esophageal strictures caused by postoperative anastomosis in 5 cases, sclerotherapy in 4 cases, caustic injury in 6 cases, and malignancy in 16 cases. The success rate of balloon dilatation was 100% in postoperative anastomotic and post-scle- rotherapy strictures, 16.7% in caustic stricture, and 62.5% in malignant stricture. The addition of bougienage increased the final success rate of dilatation therapy from 16.7 to 66.7% in caustic stricture, and 62.5 to 93.8% in malignant stricture. The overall one-year recurrence rate in benign stricture was 34.5%. All of the recurrent strictures were successfully retreated by balloon dilatation. In conclusion, endoscopic balloon dilatation is a safe, effective, and easy method for the management of benign esophageal strictures except longstanding caustic stricture, and can be used as an auxiliary therapy prior to more definitive treatments such as esophageal intubation in malignant stricture.
Constriction, Pathologic* ; Dilatation ; Esophagus ; Intubation ; Recurrence ; Sclerotherapy

No abstract available.
Infertility* ; Laparoscopy*

No abstract available.
Drug Therapy* ; Lung*

Familial hemophagocytic lymphohistiocytosis (FHL) is a rare disease characterized by fever, hepatosplenomegaly, cytopenia and non-malignant lymphohistiocytic infiltration with hemophagocytosis in reticulendothelial organs. We experienced three cases of FHL in identical male twins and their younger brother who presented with fever and severe hepatosplenomegaly. Cytopenia, elevated serum transaminase and low serum albumin levels, hypertriglyceridemia were common laboratory findings of them. One of them showed markedly decreased phytohemagglutinin induced lymphocyte proliferation and reversed CD4/CD8 ratio (0.52) in flowcytometric lymphocyte subset analysis. Aspirate of bone marrow revealed typical features consistent with FHL in two of them. In spite of recent therapeutic approaches, none of them survived.
Bone Marrow ; Fever ; Humans ; Hypertriglyceridemia ; Lymphocyte Subsets ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Male ; Rare Diseases ; Serum Albumin ; Siblings

Microsatellites are short nucleotide repeat sequences present throughout the human genome. Alterations of microsatellites, comprising extra or missing copies of these se quences, have been termed microsatellite instability(MSI, genetic instability, replication errors, RER(+) phenotype). To date, at least four genes involved in DNA mismatch repair, hMSH2, hMLH1, hPMS1 and hPMS2, are thought to account for the observation of microsatellite instability in tumor from Hereditary nonpolyposis colorectal cancer (HNPCC) patients. The genetic defect responsible for the MIN+ phenotype in sporadic colorectal cancer, however, has yet to be clearly delineated. The purpose of this study was to determine the presence of MSI in sporadic cancer and to correlate its occurrence with clinicopathological parameters, we have studied six microsatellite loci by use of polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. We found that 20%(9 of 46 cases) sporadic colorectal cancers showed RER at two or several loci(RER+). Microsatellite instability was associated with location of the tumor in the proximal colon 66%(6 of 9 cases) and with poorly differentiated tumor phenotype 56%(5 of 9 cases). In order to better understand the role of somatic alterations within hMSH2 in the process of colorectal tumorigenesis, we examined the most conserved regions(codon 598~789) of this gene in nine patients with MIN spotadic colorectal cancer. 6 patient of RER(+) colorectal ca. patients had a polymorphism which was a T to C base change in the intron sequence at -6 position of the splice acceptor site at the 5'end of exon 13. This particular sequence variation is a polymorphism rather than a mutation which increase cancer susceptability. These data suggest that the genetic instability is detect ed in some colorectal cancers and play an important role in the pathogenesis of sporadic colorectal cancer.
Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Electrophoresis, Polyacrylamide Gel ; Exons ; Genome, Human ; Humans ; Introns ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction ; RNA Splice Sites

Lichen nitidus(LN) is an unaommon chronic eruption of numerou tiny, discrete, usually flesh colored, shiny papules most cornmonly located on the penis, arms, for arms, and abdomen. It was described by Pinkus, first in 1901. The distribution of LN is most often locaized, but in some cases it may become generalized. A 10-year-old healthy boy was seen by our department because of many flesh colored, discrete, shiny papules on the whole body. The papules are skin colored, pinhcad sized, round, and flat-topped. The lesions appeared first at the age of 9 on the forehead and then neased in the number and extended downward to the neck, trunk, abdornen and both extremities. This case was successfully treated with topical corticosteroid.
Abdomen ; Arm ; Child ; Extremities ; Forehead ; Humans ; Lichen Nitidus* ; Lichens* ; Male ; Neck ; Penis ; Skin

We report a case of focal dermal hypoplasia associated with ichthyosis in an 18-year-old Korean female. The patient showed a yellowish atrophic patch on the left side of her abdomen, abnormal skin pigmentation, nail dystrophy and ichthyosis since birth.We could also find skeletal and dental deformities. The biopsy specimen obtained from the yellowish atrophic patch showed marked attenuation of collagen fibers and ectopic fatty tissue nearly reaching up to the upper dermis.
Abdomen ; Adipose Tissue ; Adolescent ; Biopsy ; Collagen ; Congenital Abnormalities ; Dermis ; Female ; Focal Dermal Hypoplasia* ; Humans ; Ichthyosis* ; Skin Pigmentation

We report a case of focal dermal hypoplasia associated with ichthyosis in an 18-year-old Korean female. The patient showed a yellowish atrophic patch on the left side of her abdomen, abnormal skin pigmentation, nail dystrophy and ichthyosis since birth.We could also find skeletal and dental deformities. The biopsy specimen obtained from the yellowish atrophic patch showed marked attenuation of collagen fibers and ectopic fatty tissue nearly reaching up to the upper dermis.
Abdomen ; Adipose Tissue ; Adolescent ; Biopsy ; Collagen ; Congenital Abnormalities ; Dermis ; Female ; Focal Dermal Hypoplasia* ; Humans ; Ichthyosis* ; Skin Pigmentation

No abstract available.

The bone marrow biopsy is an integral part of the staging process in patients with malignant lymphomas. Bone marrow(BM) involvement indicates stage IV disease, but there are always a lot of cases in which clear separation is not possible when based on morphology alone. Additional difficulties are caused by morphologic discordance between the BM and the primary lymphoma. Immunohistochemical stain, mRNA in situ hybridization (ISH) for light chain restriction and polymerase chain reaction (PCR) for IgH CDR3 and TCRgamma were performed to find a minimal lesion and the clonality in formalin fixed paraffin embedded tissues of 39 primary lymphomas and corresponding BM biopsy specimens. As a result, nine morphologically negative bone marrows of 18 lymphomas were positive by PCR (Group I). Among the 6 lymphoma cases with morphologically suspicious BM involvement (Group II), one was confirmed to be positive for marrow involvement by both mRNA ISH and PCR and the other four by PCR alone. The positive bone marrows of Group I and II revealed gene rearrangement at the same site as the primary lesion, suggesting the same clonality. Thirteen of 15 lymphomas with morphologically positive BM (Group III) had the same clonality in the primary lymphomas and the BM lesion. Three cases among the Group III with morphologic discordance also revealed the same clonality by PCR. This study shows that a combination of mRNA ISH and PCR in addition to an immunohistochemical stain improves the diagnostic sensitivity in the detection of BM involvement and identification of clonality. Among the three different methods used, PCR is the most sensitive in detecting a minimal lesion.
Biopsy ; Bone Marrow ; Formaldehyde ; Gene Rearrangement ; Humans ; In Situ Hybridization ; Lymphoma* ; Paraffin ; Polymerase Chain Reaction ; RNA, Messenger