Lymphomatoid papulosis is a strange disease; clinically benign, histologically malignant. Clinically, it may simulate pityriasis lichenoides et varioliformis acuta. The diagnosis is based on the typical histopathological features suggestive of malignant lymphoma, due to the presence of polymorphous lymphoid infiltrate consisting of small lymphocytes intermingled with conspicuous large atypical cells. We experienced a case of lymphomastoid papulosis in 35-year-old woman. Initially, her skin lesions developed as erythematous papules on the extremities, gradually spreading centrifugally with a tendency to involute slowly without treatment, leaving brown wrinkled surface and shallow ulceration. These skin lesions tended to become worse in warm weather and better in cold weather. At first visit, multiple erythematous grouped, ulcerated papules and nodules are seen. 18 months after first visit, most skin lesions are regressed except 5 erythematous pinhead sized papules on right leg in spite of no treatrnent. Labcratory examiniations of CBC, VDRL, urinatlysis, blood chemistry and chest X-ray were all within normal limits. Histopathologically there were hygerkeratosis, mild acanthosis, exocytosis in epidermis, and numerous lymphoid cells were infiltrated especially on perivascular and periappendegeal area, and many atypical cells showing hyperchromatic nuclei, kidney-shaped nuclei and mitotic figures in dermis.
Adult ; Chemistry ; Dermis ; Diagnosis ; Epidermis ; Exocytosis ; Extremities ; Female ; Humans ; Leg ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis* ; Pityriasis Lichenoides ; Skin ; Thorax ; Ulcer ; Weather

Proliferations of the endometrial glands form a continuum from focal glandular crowding through simple hyperplasia, complex hyperplasia and atypical hyperplasia to frank adenocarcinoma. But objective criteria to distinguish these proliferative endometrial lesions are not clear-cut and terminology is confusing. The p53 protein is a nuclear phosphoprotein that can regulate cell proliferation and suppress tumor growth. Mutation in the p53 gene have been reported in a variety of human tumors, and in selected malignancies overexpression of p53 has been associated with poor prognosis. In this study we examined a series of endometrial proliferative lesion, including hyperplasia, adenocarcinoma, and adenomyosis to determine whether or not p53 is overexpressed in these lesions. In the result, p53 immunoreactivity was observed in 3 of 17 (17.6%) simple hyperplasia, one of 6 (16.6%) complex hyperplasia, none of 3 (O%) atypical hyperplasia, 6 of 13 (46.1%) adenocarcinoma and none of 10 (O%) adenomyosis. In conclusion, p53 mutation seems to play a role in oncogenesis of endometrial adenocarcinoma in early phase but there was no significant relationship between p53 overexpression and histologic grade of adenocarcinoma.
Adenocarcinoma* ; Adenomyosis ; Carcinogenesis ; Cell Proliferation ; Crowding ; Endometrial Hyperplasia* ; Female ; Genes, p53 ; Humans ; Hyperplasia ; Prognosis

OBJECTIVES: Risk taking has been implicated in the development of various psychiatric disorders. Previous studies have indicated that risk taking behavior is associated with high levels of impulsiveness. Risk taking entail uncertain situation that outcome probability is unknown. This study tested impulsivity, intolerance of uncertainty and risk taking behavior. METHODS: A total of 73 participants completed a test battery comprised of the UPPS-P scale as a psychometric measurement of five dimensions of impulsivity, Intolerance of Uncertainty Scale, and Balloon Analog Risk Task (BART) as a behavioral measure of risk taking. The Pearson correlation analysis was used. RESULTS: The sensation seeking factor was positively correlated with BART measure (r = 0.27, p = 0.02). Specifically, the relationship between sensation seeking and BART was significant in females. CONCLUSIONS: Among the five factors of UPPS-P, only the sensation seeking factor predicts risk taking propensity.

Chronic ruptures of the patellar tendon are uncommon injuries. They are technically difficult to repair because of scar formation, poor quality of the remaining tendon, and quadriceps muscle atrophy and contracture. We report a case on the reconstruction of a chronic patellar tendon rupture. The reconstruction was performed 18 months after the injury, using an Achilles tendon allograft and reinforcing suprapatellar wire. At four weeks postoperative, the patient had attained 70degrees C flexion and 10degrees C extension lag. Nine months after the index procedure, the patient regained 130degrees C flexion and 5degrees C extension lag, and 85% quadriceps strength. The technique accomplished the preoperative goals of restoring quadriceps function and anatomic position of the patella as well as allowing early mobilization after surgery. Although this reconstructive procedure is technically demanding, the functional results obtained can be excellent. We recommend the use of this technique for chronic patellar tendon ruptures that cannot be primarily repaired.
Achilles Tendon ; Allografts* ; Atrophy ; Cicatrix ; Contracture ; Early Ambulation ; Humans ; Patella ; Patellar Ligament* ; Quadriceps Muscle ; Rupture* ; Tendons

In situ follicular lymphoma is a newly defined entity among the lymphoid neoplasms and is defined as architecturally normal-appearing lymph nodes and other lymphoid tissues that have one or more follicles that demonstrate bcl-2 overexpressing centrocytes and centroblasts, with or without a monomorphic cytologic appearance suggestive of follicular lymphoma. Here we present a case of in situ follicular lymphoma diagnosed during the follow-up after a complete response to the treatment of lymphocyte-rich classical Hodgkin's lymphoma. In our case, because only a few germinal centers contained bcl-2 overexpressing cells, we missed the diagnosis of in situ follicular lymphoma in the initial histological examination. We could establish the diagnosis only after performing bcl-2 immunostaining in the sequential biopsy. Therefore, we recommend that careful histological examination along with bcl-2 immunostaining is needed in patients with suspicious clinical findings.
Biopsy ; Follow-Up Studies ; Germinal Center ; Hodgkin Disease ; Humans ; Lymph Nodes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, Follicular ; Precancerous Conditions

Dopa-responsive dystonia (DRD) is a slowly progressive dystonia with childhood onset and is characterized by marked diurnal fluctuation of symptoms, dramatic response to levodopa treatment and concurrent signs of parkinsonism. We report a 16-year-old girl diagnosed as DRD. Around the age of 11, gait disturbance was developed with equinocavovarus deformity of both feet. The plantar fasciotomy, triple arthrodesis and posterior tibialis tendon transfer for left foot with the diagnosis of cerebral palsy were done. She complained of a persistent dystonia of all extremities after operation and was successfully treated with low-dose levodopa after a diagnosis of DRD. For the accurate diagnosis and prevention of unnecessary operation, trial of levodopa is warranted in patients suspected with cerebral palsy with similar symptoms of DRD.
Adolescent ; Arthrodesis ; Cerebral Palsy ; Congenital Abnormalities ; Diagnosis ; Dystonia* ; Extremities ; Female ; Foot ; Gait ; Humans ; Levodopa ; Parkinsonian Disorders ; Tendon Transfer

We present a patient with primary hyperparathyroidism in whom preoperative Tc-99m sestarnibi scanning cleary demonstrated mediastinal parathyroid adenoma. After resectian of tumor through median sternotomy, he was restored to the normocalcemia. This case suggests that Tc-99m sestamibi scanning may be a useful method in the preoperative localization of mediastinal parathyroid adenoma.
Humans ; Hyperparathyroidism, Primary ; Methods ; Parathyroid Neoplasms ; Sternotomy

Arthroscopic synovectomy is a widely-used method to treat septic knee arthritis. To date, many authors have reported minimal complications related to arthroscopic treatment, especially vascular injuries. A three-dimensional computed tomography angiography revealed a pseudoaneurysm that arise from the popliteal artery near the arthroscopic site in septic arthritis patients with atherosclerosis and neurofibromatosis. A careful arthroscopic procedure via the posteromedial or posterolateral portal is recommended for the prevention of this complication. We, therefore, recommend close observation after arthroscopic procedure, despite the occurrence of complications; nonetheless, early diagnosis and treatment are important. We report a case of pseudoaneurysm of the popliteal artery with a complicating arthroscopic synovectomy in septic arthritis with literature review.
Aneurysm, False ; Angiography ; Arthritis ; Arthritis, Infectious ; Arthroscopy ; Atherosclerosis ; Debridement ; Early Diagnosis ; Humans ; Knee ; Methods ; Neurofibromatoses ; Popliteal Artery ; Vascular System Injuries

BACKGROUND: Identification of antigen-specific T cells has yielded valuable information on pathologic process and the disease state. Assays for quantification of inflammatory cytokines or lytic-granule molecules have been generally used to evaluate antigen specific T cell response, however their applicability have been hampered due to the limited source of autologous antigen-presenting target cells (APC). METHODS: K562, a leukemic cell line deficient of human leukocyte antigen (HLA), was transfected with a gene encoding HLA-A*02 (K562/A*02) and its function as stimulator cells in inducing activation of HLA-matched T cells was evaluated by IFN-gamma enzyme linked immunospot (ELISPOT) assay. RESULTS: The stable transfectant K562/A*02 pulsed with HLA- A*02 restricted peptide could specifically induce IFN-gamma secretion by CD8+ T cells compared to no detectable secretion by CD4+ T cells. However, CD56+ NK cells secreted IFN-gamma in both K562/A*02 with peptide and without peptide. The number of IFN-gamma secreted CD8+ T cells was increased according to the ratio of T cells to K562 and peptide concentration. Formalin-fixed K562/A*02 showed similar antigen presenting function to live K562/A*02. Moreover, K562/A*02 could present antigenic- peptide to not only A*0201 restricted CD8+ T cells but also CD8+ T cells from A*0206 donor. CONCLUSION: These results suggest that K562/A*02 could be generally used as target having specificity and negligible background for measuring CD8+ T cell responses and selective use of K562 with responsder matched HLA molecules on its surface as APC may circumvent the limitation of providing HLA-matched autologous target cells.
Cell Line ; Cytokines ; Genes, vif ; Humans ; K562 Cells* ; Killer Cells, Natural ; Leukocytes ; Peptides ; Sensitivity and Specificity ; T-Lymphocytes ; Tissue Donors

BACKGROUND AND OBJECTIVES: There has been a need for functional status measurement tool with better validity than the existing tools such as New York Heart Association Functional Class. Duke Activity Status Index (DASI) is a representative example of a tool that was developed to enhance the validity of measurement by asking the patients about the ability to perform specific activities and scoring the response. Because such a tool must be culture-sensitive, it is desirable to use 'Koreanized' version of the tool. No Koreanized version of the functional status measurement tool has been developed yet. The objective of this study is to develop a Korean version of DASI. MATERIALS AND METHOD: In the developmental phase, a pilot questionnaire asking the ability to perform specific activity was made with reference to existing tools, such as Specific Activity Scale and DASI. Substitution, correction and addition of items were done through the pilot study. Ninety-nine patients was asked to fill developmental version of questionnaire, then underwent treadmill exercise test. Weight for each items were assigned to optimize the correlation between the calculated index (KASI) and total treadmill exercise time. Criteria for categorical functional classification were determined to maximize the agreement between KASI-estimated functional class (KASIFC) and functional class estimated by exercise time. In the validation phase, final version of questionnaire was tested in independent group of 159 patients. The questionnaire was self-administered. Canadian Cardiovascular Society Functional Class (CCSFC) was estimated by the physician who is in charge of treadmill exercise test. RESULTS: In the validation phase, Spearman correlation coefficient between KASI and treadmill exercise time was 0.62(p=.0001) and between CCSFC and exercise time -0.48(p=.0001). KASIFC agreed with functional class estimated by exercise time in 77% of cases, disagreed by 1 class in 20% and by 2 classes in 1%. KASIFC agreed with functional class estimated by exercise time in 77% of cases, disagreed by 1 class in 20% and by 2 classes in 1%. These two methods did not differ significantly in categorical classification. CONCLUSION: KASI is more accurate or at least as accurate as the existing tool in estimation of functional status. The characteristics such as self-administration, availability of outcome as a continuous variable are expected to make it a convenient, efficacious and useful tool in various clinical researches.
Classification ; Exercise Test ; Heart ; Humans ; Pilot Projects ; Surveys and Questionnaires