Leiomyoblastoma is uncommon and has been known as a neoplasm of smooth muscle origin. However, with recent pragress in immunohistochemical staining techniques, many clinicopathological discrepancies have been pointed out about the origin of leiomyoblastoma. We present here a case of gastric leiomyoblastoma did not expressed desmin and neuron specific enolase, and was thought to be of unknown derivation.
Desmin ; Leiomyoma, Epithelioid* ; Muscle, Smooth ; Phosphopyruvate Hydratase

Leiomyoblastoma is uncommon and has been known as a neoplasm of smooth muscle origin. However, with recent pragress in immunohistochemical staining techniques, many clinicopathological discrepancies have been pointed out about the origin of leiomyoblastoma. We present here a case of gastric leiomyoblastoma did not expressed desmin and neuron specific enolase, and was thought to be of unknown derivation.
Desmin ; Leiomyoma, Epithelioid* ; Muscle, Smooth ; Phosphopyruvate Hydratase

PURPOSE: The purpose of this study was to define the factors affecting results in acute septic hip arthritis in children and to reduce the complications. MATERIALS AND METHODS: This is a retrospective study of 27 children with 28 hip joint infections, treated with arthrotomy and followed up for more than 12 months. Results were evaluated according to Merle D'Aubigne's clinical grade and Bennett's radiological grade, and correlated with the time between symptom onset and treatment, the existence of a causative organism, its species, concomitant osteomyelitis, age of onset and normalized time of C-reactive protein (CRP). We analysed results using the Pearson Chi Square method. RESULTS: A delay in treatment, concomitant osteomyelitis of the proximal femur and old age, were factors associated with poor prognosis. Normalized time of CRP, the existence of a causative organism and species were not correlated with the treatment results. CONCLUSION: Shorter duration of disease from clinical onset to the initiation of therapy and concomitant osteomyelitis of the proximal femur are the most important factors in the treatment of acute septic hip arthritis in children. When analysing results correlated with the age of onset, precise prospective study is required in many cases of acute septic hip arthritis in children.
Age of Onset ; Arthritis ; Arthritis, Infectious* ; C-Reactive Protein ; Child* ; Early Diagnosis ; Femur ; Hip Joint* ; Hip* ; Humans ; Osteomyelitis ; Prognosis ; Retrospective Studies

The Orthotopic liver transplantation for the terminal liver diseases has been performed frequently since the introduction of new immuno-suppressive agent (cyclosporin A), technical advances in surgical skill, uae of biopump during anhephatic stage, rapid infusion system for transfusion and thromboelastography for coagulopathies were used. In Korea, only one case of orthotopic liver transplantation succeeded in 1988, but the animal experiments have been going on for many years in many institutes. Orthotopic liver transplantation in dogs using centrifugal pump (Bio-pump) were experienced and the results were analysed; 1) There were no differences in hemodynamic parameters during anhepatic stage with assistance of Biopump compared with preanhephatic stage. 2) The mean flow rate of Biopump during anhepatic stage was 0.75+/-0.09L/min, and maximun and minimum flow rate were 1.5L/min. and 0.4L/min, respectively. 3) Mean artery pressure, cardiac output and systemic vascular resistance after reperfusion of transplanted liver were significantly reduced compared with the values of before reperfusion; meanwhile, mean pulmonary artery pressure, pulmonary capillary wedge pressure and pulmonary vascular resistance were not significantly different. 4) After reperfusion of transplanted liver serum potassium level was significantly increased to 6. 07+/-1.8 mEq/L and the amount of base was significantly decrease to-12.9+/-5.9 mEq/L. By using Bio-pump the degree of hemodynamic changes could be reduced during the clamping of inferior vena cava and hepatic vein.
Academies and Institutes ; Animal Experimentation ; Animals ; Arteries ; Cardiac Output ; Constriction ; Dogs* ; Hemodynamics ; Hepatic Veins ; Korea ; Liver Diseases ; Liver Transplantation* ; Liver* ; Potassium ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Reperfusion ; Thrombelastography ; Vascular Resistance ; Vena Cava, Inferior

BACKGROUND: Although determination of Doppler echocardiographic transmitral inflow patterns(DETIP) is used as an indrect method assessing LV diastolic function. It is known that DETIP can be affected by certain hemodynamic variables. The aim of this investigation is to assess the serial changes of DETIP and to determine the relation of DETIP with clinical parameter such as initial left ventricular end-diastolic volume(LVEDV), ejection fraction(EF), Killip class and thrombolytic therapy in acute myocardial infarction (AMI) patients. METHOD: Four serial Doppler and 2-D echocardiographic studies were performed at 1 day, 1 week, 1mouth, and 3 months after development of AMI in 24 patients(M:F=19:5, aged 58+/-11 year , 15 anterior MI) and 13 normal adults (aged 47+/-9 years) as reference group. On admission 14 patients were in Killip class I and 10 patients in class II. Thrombolytic therapy with IV urokinase were done in 11 patients. E velocity, pressure half-time (PHT), and isovolumic relaxation time(IVRT) were analyzed and LV systolic function was determined in apical 4 chamber view. RESULTS: DETIP did not change until 1month after development of AMI. However, E/A ratio was decreased, and PHT and IVRT were increased at 3 months after AMI. Doppler transmitral flow parameters were not related with Killip class and LV systolic function. Patiens who recieved urokinase intravenously and who had greater intial LVEDV(>118cm3) showed higher E/A ratio and shorter PHTand IVRT than those who did not. These findings indicate that changes in Doppler transmitral inflow pattern in AMI patients are not uniform over a period of 3 months and thrombolytic therapy causes favorable effect on Doppler transmitral flow parameters. CONCLUSION: Changes in Doppler trasmitral inflow pattern may be variable over post-AMI period and this should be taken into account in evaluating LV diastolic function after AMI. Thrombolytic therapy may improve LV diastolic function in AMI patients.
Adult ; Echocardiography ; Hemodynamics ; Humans ; Myocardial Infarction* ; Relaxation ; Thrombolytic Therapy ; Urokinase-Type Plasminogen Activator

PURPOSE: Various causes may be the etiology of gynecomastia. We investigated the levels of serum estradiol (E2), testosterone (T), ratio of E2 to T (E2/T) as well as associated diseases, drugs as the cause of gynecomastia. MATERIALS AND METHODS: E2, T, E2/T in 37 patients from gynecomastia patients (GP) and 10 healthy men were measured, and the associated diseases and drugs in 68 GP were also evaluated. Ultrasound for the adrenal gland diseases, physical examination or ultrasound for the testicular pathology were performed. RESULTS: The cause of gynecomastia varied according to the age. The levels of E2, T, E2/T in control group (CG) were 35.3 3.9 pg/ml, 5.0 0.4 ng/ml, 7.1 0.5. Those in GP were 48.7 7.1 pg/ml, 4.3 0.3 ng/ml, 12.0 1.8, respectively. The difference of E2/T as well as E, T between CG and GP was not significant. Various associated diseases or drugs were found in GP. Adrenal diseases or testicular cancer were not found in GP. CONCLUSIONS: The difference of E2/T between CG and GP is not the only cause of gynecomastia. Thus, the consideration of the age as well as associated diseases or drugs will be helpful for the better understanding of high E2/T as the cause of gynecomastia
Adrenal Gland Diseases ; Estradiol ; Gynecomastia* ; Humans ; Male ; Pathology ; Physical Examination ; Testicular Neoplasms ; Testosterone ; Ultrasonography

A systemic treatment of granulocyte-colony stimulating factor (G-CSF) is known to improve healings of damaged tissues. However, recent studies suggested local actions of G-CSF on the healing processes of damaged tissues. We investigated the treatment effect of locally injected G-CSF and compared to that of systemically injected G-CSF in a rat model. A wound was created on the rat dorsum and treated either by local injection or by systemic injection of G-CSF. Wound healing rate, deposition of collagen, and gene expression were evaluated. G-CSF receptor (G-CSFR) protein was detected by Western blotting. The wound healing rate in the local injection group was significantly higher than that in the systemic injection group at days 9 and 15; it was also significantly higher than that in the control group at days 3, 9, and 15. The expression of G-CSFR protein in wound tissues was higher than in normal skin tissues. The local injection of G-CSF is more effective than systemic injection of G-CSF in promoting wound healing, which may implicate the local action of G-CSF treatment in wound healing processes.
Animals ; Blotting, Western ; Collagen ; Gene Expression ; Granulocyte Colony-Stimulating Factor ; Models, Animal ; Rats* ; Receptors, Granulocyte Colony-Stimulating Factor ; Skin ; Wound Healing* ; Wounds and Injuries*

A myxedema coma, representing the extreme feature of hypothyroidism is rare. Despite early vigorous treatment, a myxedema coma is associated with a mortality rate as high as 60%. Herein, a case of a myxedema coma, with severe hypoventilation, is described. When the patient arrived at the emergency room, she complained of dyspnea and general weakness, and was of a drowsy mental status. 7 days after admission, she was more confused and disoriented, and respiratory insufficiency had developed. Although levothyroxine was continued and her respiration improved, she still had a confused mentality and seizure developed. Despite medication her consciousness did not improve, so was discharged in despair by her family members. The respiratory abnormality with a myxedema coma is a depressed ventilatory response to hypercapnea, resulting in a decrease in alveolar ventilation, with progressive CO2 retention. An upper airway obstruction, especially during sleep, and neuromuscular dysfunction in breathing may be shown in hypothyroidism. Therefore, a myxedema coma, accompanied by severe hypoventilation, should be intensively treated with thyroid hormone replacement therapy and mechanical ventilatory support
Airway Obstruction ; Coma* ; Consciousness ; Dyspnea ; Emergency Service, Hospital ; Hormone Replacement Therapy ; Humans ; Hypothyroidism ; Hypoventilation* ; Mortality ; Myxedema* ; Respiration ; Respiratory Insufficiency ; Seizures ; Thyroid Gland ; Thyroxine ; Ventilation

BACKGROUND/AIMS: The QuantiFERON-TB Gold (QFT-G) and QuantiFERON-TB Gold in tube (QFT-IT) assays have been studied primarily for the use of diagnosing active pulmonary tuberculosis (TB) or latent TB. The clinical usefulness of these assays for the detection of active extrapulmonary (EP) TB has not been fully defined. The aim of this study was to compare the diagnostic value of these two interferon-gamma assays for EP-TB. METHODS: From June 2007 to August 2010, we evaluated the usefulness of QFT-G (n = 56) and QFT-IT (n = 48) in patients (n = 104) with suspected EP-TB. The diagnostic sensitivity, specificity, postive predictive value (PPV), and negative predictive value (NPV) of QFT-G and QFT-IT, and the cut-off value of QFT-IT were analyzed. RESULTS: EP-TB was diagnosed in 55 (53%) patients. The overall sensitivity, specificity, PPV, and NPV of the QFT-IT assay were 96%, 42%, 62%, and 91%, respectively, and those of the QFT-G test were 81%, 52%, 68%, and 68%, respectively. In subgroup analyses according to infection site, the sensitivity and NPV of QFT-IT were higher than those of QFT-G. Analysis confirmed that the manufacturer's recommended test cut-off value fell within our cut-off value range (0.30-0.45 IU/mL; 95.8% sensitivity, 41.7% specificity). CONCLUSIONS: The QFT-IT assay showed superior sensitivity and NPV, and equivalent specificity, as comparison with the QFT-G test for the detection of Mycobacterium tuberculosis infection. The logistic benefits of the QFT-IT test format should facilitate the diagnosis of EP-TB.
Humans ; Interferon-gamma ; Lymphadenitis ; Mycobacterium tuberculosis ; Sensitivity and Specificity ; Spondylitis ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Linezolid, an oxazolidinone, has shown efficacy in the treatment of adults with nosocomial or community-acquired pneumonia, skin and soft tissue infections (SSTI), and infections due to methicillin-resistant Staphylococcus aureus. We have taken part in the study for evaluation of efficacy and safety of linezolid for the treatment of suspected or proven gram-positive SSTI in Asia. We sub-analyzed and reported the results of the study among Korean patients. MATERIALS AND METHODS: A total of 60 patients were enrolled in the study for evaluation of efficacy and safety of linezolid for the treatment of gram-positive SSTI at eight teaching hospitals in Korea. We investigated patients' medical history, physical examination and laboratory study. Patients were regularly followed up to evaluate clinical response, laboratory changes, and adverse event up to 4 weeks after treatment. When possible, we performed microbiological study before and after treatment. RESULTS: A total of 60 patients were enrolled. Average age of the patient was 50.9+/-15.3 years old with male to female ratio being 1.3:1. Cellulitis, open wound infection, skin abscess, and other clinical manifestations were observed in 47 (78.3%), 6 (10.0%), 2 (3.3%), and 5 (8.3%) patients, respectively. Forty two patients completed both follow-up and treatment and among them, treatment was successful in 38 patients (90.5%) and unsuccessful in 4 patients (9.5%). Microoranisms were isolated from seven patients and 14 isolates were documented; 11 S. aureus, 3 coagulase-negative staphylococcus. Among the seven patients, bacteria were eradicated in four patient and the organism proved to be colonization in three patients. The most frequent drug-related adverse events were gastrointestinal (21.7%), hematologic and biochemical (21.7%) and neurologic (3.3%), in decreasing order. Nausea (15%) was the most frequent symptom and there were no serious side effects related to linezolid. CONCLUSION: Linezolid was effective and safe in treatment of gram-positive SSTI.
Abscess ; Adult ; Asia ; Bacteria ; Cellulitis ; Colon ; Female ; Follow-Up Studies ; Hospitals, Teaching ; Humans ; Korea ; Linezolid ; Male ; Methicillin-Resistant Staphylococcus aureus ; Nausea ; Physical Examination ; Pneumonia ; Skin* ; Soft Tissue Infections* ; Staphylococcus ; Wound Infection