Infantile form of histiocytosis X is commonly presented as multiorgan desseminated form such as Letterer-Siwe disease. Lymph node involvement of histiocytosis X is usually accompanied by adjacent bone or skin lesion. Solitary nodal eosinophilic granuloma without evidence of other organ involvement is very rare. A case herein report is a 11 month-old female infant presented with fever and palpable both inguinal lymph nodes. There was neither skin lesion nor hepatosplenomegaly. Laboratory evaluation was within normal range except increased alkaline phosphatase and many neutrophils in urine. Radiologic examination revealed no remarkable bone lesions. And she showed good clinical outcome without evidence of other organ involvements. On microscopic examination of inguinal lymph node it was replaced by infiltration of histiocytes mainly along the sinusoid. Some of histiocytes showed morphologic features of "histiocytosis X cell" having nuclear grooves or multilobulation. Multinulceated giant cells were frequently see. Numerous eosinphils were also infiltrated and showed multifocal microabscess formation. Immunohistochemical staining revealed that majority of histiocytes were postitive for S-100 protein but multinucleated histriocytes, phagocytic histiocytes and those around the abscess were positive for macrophage marker, suck as CD68 and alpha-1-antichymotrypsin. Interestingly some histiocytes showed positivity for both S-100 protein and macrophage marker. These results suggest that histiocytosis X is proliferative disorder of phenotypically heterogenous population of histiocytes in contrast to the theory that it is a proliferative disorder of Langerhans cells.
Infant ; Male ; Female ; Humans

Previous applications of laser bone and cartilage ablation have focused largely on the CO2 and the Nd:Yag lasers, using both the continuous wave and rapid superpulsed mode, which revealed severe thermal damage such as tissue necrosis and carbonization of the remaining tissue. In contrast, Excimer lases have provided better histologic results with minimal or no thermal damage, but the ablation rate and cutting efficiency have remained unsatisfactory. Though arthroscopic partial menisectomy has become the accepted technique for dealing with tears in menisci, division of the meniscus is sometimes difficult in the confined joint space of the knee and is associated with iatrogenic injury to the articular cartilage. The ability to quickly and safely divide or remove meniscal tissue would be a distinct advantage. The Holmium:Yag laser has many potential advantages over the CO2 laster, the Nd:Yag laser and the Excimer laser. Its principal advantages include minimal mechanical trauma to the articular cartilage, greater access to tight or restricted area of the knee joint, and its ability to function in a saline medium and to resect meniscus with minimal tissue necrosis. We have evaluated the effectiveness of the Holmium:Yag laser 74 partial menisectomies of 57 patients. Among 74 meniscal tears, there were 35 medial and 39 lateral meniscal tears. The average operation time was 33 minutes in the menisectomy and hospital stay was average 3 days. There was no significant carbonization on the surrounding tissue. Menisectomy of the posterior horn was safe and easy and there was minimal iatrogenic articular cartilage damage.
Animals ; Carbon ; Cartilage ; Cartilage, Articular ; Holmium ; Horns ; Humans ; Joints ; Knee ; Knee Joint ; Lasers, Excimer ; Lasers, Solid-State ; Length of Stay ; Necrosis ; Tears

We studied the left ventricular function with the use of M-mode and 2-D Echocardiography to 32 patients with congestive heart failure before and 2 weeks after medication of prazosin 2 mg tid during July 1979 and Dec. 1980 in Heart Center, Paik Hospital, In-Je Medical College, Busan, Korea. The results were following; 1) LVDeD before and after vasodilaor therapy was each 5.64+/-0.76 and 5.04+/-0.57.cm, LVSeD before and after therapy each 4.52+/-0.51 and 3.70+/-0.57cm, and F.S. before and after therapy 19.87+/-3.66 and 26.59+/-6.75%. The difference of LVSeD, LVDeD and F.S. was each statistically significant. 2) LVDeV before and after therapy was each 182.2+/-58.07 and 132.80+/-47.01 ml LVSeV before and after therapy each 92.35+/-23.60 and 50.65+/-27.21ml, and E.F. before and after therapy each 49.31+/-7.07 and 61.86+/-11.74%. The difference of LVDeV, LVSeV and E.F. was each statisitically significant. 3) LVPWTh before and after therapy was each 0.89+/-0.11 and 0.77+/-0.08cm, and Vcf before and after therapy 0.83+/-0.11 and 1.03+/-0.27 cir./sec. The difference of LVPWTh and vcf before and after therapy was each statistically significant. 4) The difference of VSTh, RVD, LAD, and Aorta Dimension before and after therapy was each statisitically significant.
Aorta ; Busan ; Echocardiography* ; Estrogens, Conjugated (USP)* ; Heart ; Heart Failure* ; Heart Ventricles* ; Humans ; Korea ; Prazosin ; Ventricular Function, Left

Mullerian adenosarcoma is a tumor composed of a mixture of glandular and stromal elements in which the glandular component appear to be neoplastic but, histologically, benign with the stromal component showing varying degrees of malingancy. We report a case of ovarian m llerian adenosarcoma with sex cord stroma differentiation in the stromal components. A 57 year-old female who presented with palpable mass in the right lower abdomen had undergone through salingo-oophorectomy. Grossly, the ovary was multicystic, and partly showed a solid appearance with multiple polypoid projections into the dilated cystic spaces. On microscopic examination, the tumor consisted of benign to borderline epithelial glands that were lined by variety of mullerian epithelia and sarcomatous component with sex cord-stromal elements, which include sertoliform tubules, Leydig cell like clusters, and granulosa cells.
Female ; Humans

Fracture of the scaphoid constitute 60% to 70% of all diagnosed carpal injury. The acute fracture will heal approximately 90% of the time if recognized early and properly immobilized. But nonunion are common since the symtoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Authors have experienced 19 cases of scaphoid nonunion and accomplished good result in all case by Russe procedure. The results were summerized as follow: 1 The cause of fratures was mainly due to fall down dinjury (36.8%). 2. The most common mechanism of the fracture was fall on the outstretched hand (52.7%). 3. Fractures were shown on the anterior-posterior, lateral and billiards view in all cases. 4. In ten cases, the fractures were found on the waist of scaphoid. 5. The cases of nonunion were probably inadequate intial treatment and delayed diagnosis. 6. The good results were obtained by bone graft according to Russe procedure.
Delayed Diagnosis ; Diagnosis ; Hand ; Humans ; Transplants

PURPOSE: This study was performed to evaluate differentiating features of spinal compression fractures between benign and metastatic lesions. MATERIALS AND METHODS: We reviewed MR imaging in 52 patients (benign 38, metastasis 14) with vertebral compression fracture. Signal intensity of fracture and uninvolved areas, presence of contrast enhancement, fragmentation, and paravertebral mass were analyzed retrospectively. RESULTS: Signal intensity of fracture site was variable in benign lesions, but low signal intensity on T1-weighted image and high on T2*-weighted image were seen in all cases of metastasis. Signal intensity of uninvolved area was high on T1-weighted image and low on T2*-weighted image in 84% of benign lesions. On the contrary, normal marrow signal intensity was not seen in the uninvolved areas of all metastatic fractures. Contrast enhancement were observed in all cases of benign & metastatic compression fractures. Fragmentation were seen in 1 case of metastasis(7%) and in 11 cases of benign lesions(29%). Paravertebral mass were seen in 5 cases of metastasis(36%) and in 7 cases of benign lesions(18%). CONCLUSION: Presence of normal marrow signal intensity in the uninvolved area of fracture site could be the most useful sign for differentiating benign causes from metastasis.
Bone Marrow ; Fractures, Compression* ; Humans ; Magnetic Resonance Imaging* ; Neoplasm Metastasis* ; Retrospective Studies

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

BACKGROUND: Recent studies have revealed that the splicing factor neuro-oncological ventral antigen 1 (NOVA1) is enriched in fibroblasts and accumulated T cells of tertiary lymphoid structures. In the present study, we investigated NOVA1 expression in various subtypes of mature and immature T- and natural killer (NK)-cell lymphomas as well as in various B-cell lymphoma subtypes. METHODS: NOVA1 immunoexpression was evaluated in hyperplastic palatine tonsils (n = 20), T- and NK-cell lymphomas (n = 177), diffuse large B-cell lymphomas (n = 151), and other types of B cell lymphomas (n = 31). Nuclear staining intensity and percentage of positive tumor cells were graded. NOVA1 mRNA expression was analyzed in various lymphoma cell lines. RESULTS: Tumor cells of T- and NK-cell lymphomas showed higher expression levels of NOVA1 than did normal paracortical T cells, and 56.5% of T- and NK-cell lymphoma cases showed diffuse and strong expression. The NOVA1 expression level varied according to the subtype; it was higher in angioimmunoblastic T-cell lymphoma, anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma (ALCL), and T lymphoblastic leukemia/lymphoma (T-LBL), but it was lower in ALK-positive ALCL. In almost all B-cell lymphomas, NOVA1 expression was very low or negative. NOVA1 mRNA was also expressed in Jurkat, a T-LBL cell line. CONCLUSIONS: The present findings suggest that NOVA1 upregulation may be involved in certain subtypes of T- and NK-cell lymphomas, but not in B-cell lymphomas. Upregulated NOVA1 expression seems to be a specific biological feature of activated T cells such as T- and NK-cell lymphomas.
Cell Line ; Fibroblasts ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Palatine Tonsil ; Phosphotransferases ; RNA, Messenger ; T-Lymphocytes ; Up-Regulation

PURPOSE: To analysis of the clinical aspects of axillofemoral (AXFBG) and aortofemoral bypass (AOFBG) for aortoiliac occlusive disease. METHODS: Between June 1996 and May 2001, 23 patients underwent AXFBG or AOFBG for lower extremity ischemia caused by aortoiliac occlusive disease at Samsung Medical Center. The decision to perform AXFBG or AOFBG was based on an assessment of surgical risk and the patient's preference. We retrospectively analyzed the preoperative clinical status, risk factors and distal runoff scores affecting the patency rate as well as the clinical outcome following surgery. RESULTS: We performed 10 AXFBGs and 13 AOFBGs. The mean age was 67.8 years in AXFBG patients and 57.4 years in AOFBG patients. Limb salvage as an indication for surgery included 8 (80%) cases with AXFBG, as compared to 13(100%) cases with AOFBG. The mean follow-up period was 20.7 months in AXFBG and 21.8 months in AOFBG. The clinical improvement following surgery was statistically higher with AOFBG. The one-year and 2-year primary patency rates in AXFBG were 100% and 82% retrospectively. All of the grafts of AOFBG were patent during this follow-up period. CONCLUSION: The clinical improvement was higher with AOFBG as compared to AXFBG. However AXFBG is a safe practice in high-risk patients.
Follow-Up Studies ; Humans ; Ischemia ; Limb Salvage ; Lower Extremity ; Retrospective Studies ; Risk Factors ; Transplants

Paraduodenal hernias are a rare congenital malformation, but they are the most common internal hernias. They develop secondary to a failure in midgut rotation, which may lead to small bowel obstruction or other clinical manifestations. The authors recently experienced a case of a left paraduodenal hernia presenting with unusual symptoms of left flank pain and vomiting.
Adult ; Hernia/*complications/*diagnosis/pathology/surgery ; Humans ; Intestinal Obstruction/*etiology/surgery ; Male