BACKGROUND: Angiocentric T-cell lymphomas are rare T-cell malignancies which involve extranodal sites, such as the skin, nasal cavity, soft tissue and gastrointestinal tract. They have been reported with significant frequency in Asia. OBJECTIVES: The main objective of this study is to characterize the clinical, pathological, and immunohistochemical featnres of cutaneous angiocentric T-cell lymphoma. Another objective is to search for the Epstein-Barr virus (EBV) in the tissues of cutaneous angiocentiric T cell lymphoma. METHODS: Clinical records, laboratory data, and histopathologic sections of 12 patients with cutaneous angiocentric T-cell lymphoma were reviewed. Paraffin tumor tissues were immunophenotyped. In situ hybridizaion studies were performed to detect the EBV genomes. RESULTS: The ages of the 12 patients ranged from 34 to 64 years(mean 45.8 years). The cutaneous lesions were nodules or plaqes, and were with ulcerated or had intact skin. Eight patients had evidence of extracutaneous involvement, usually involving lymph nodes, liver, and spleen. Eleven patients showed the abnormal laboratory findings including anemia, leukopenia, and elevated level of LDH. The disease pursued an aggressive course and was not uncommonly resistant to treatment. Histologically, the lymphomatous infiltrate occurred predominantly in the subcutaneous layer with involvement of the dermis. The pattern was mainly perivascular and periadnexal. A prominent feature was invasion of small or medium vesselsby lymphoma cells. The infiltrating lymphrcytes expressed CD45RO in all cases; variable expression of CD3 and CD56 was detected in piaffin sections. Among the 11 cases where in situ hybridization was performed, EBV genome could be detected in 9 cases. CONCLUSION: Angiocentric T-cell lymphoma of the skin is an aggressive lymphoma distinct from classic cutaneous T-cell lymphoma. However, further studies are needed to regard them as a homogeneous entity of T-cell lymphoma involving the skin.
Anemia ; Asia ; Dermis ; Gastrointestinal Tract ; Genome ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leukopenia ; Liver ; Lymph Nodes ; Lymphoma* ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Nasal Cavity ; Paraffin ; Skin* ; Spleen ; T-Lymphocytes ; Ulcer

A prospective analysis of 80 consecutive operated cases of aneurysm were carried out to know the prognostic factors in intracranial aneurysmal surgery. Analysis of end-results with respect to aneurysmal locations and timing of operation showed that the internal carotid artery aneurysm did not make difference in outcome regardless of the timing of surgical intervention, but anterior cerebral artery, middle cerebral artery, and multiple aneurysm were more poor outcomes in the early surgical group(p<0.05). The more grave initial neurological state showed the worse surgical end-results. The poor results were shown in cases of above 3 mm in thickness of the basal cisternal hemorrhage and/or above 30 ml in volume of the intracerebral hematoma on the brain CT scan. During the operation, no sunkened brain, a spasm of offending artery, premature rupture of aneurysm, and post-operative residual intracerebral hematoma were also adverse effects to the post-operative outcomes.
Aneurysm ; Anterior Cerebral Artery ; Arteries ; Brain ; Carotid Artery, Internal ; Hematoma ; Hemorrhage ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Prospective Studies ; Rupture ; Spasm ; Tomography, X-Ray Computed

Neurilemmoma, also called schwanomma, neurinoma, and perineural fibroblastoma is a rare benign tumor originated from the schwann cell of nerve sheath. They occur commonly at 20-50 aged person and involved the head and neck and flexor surface of the extremity. Histologically, they are characterized by Antoni A and Antoni B tissue composed of high and low cellularity. Primary neurilemmoma involved in the bronchial wall is extremely rare and few cases have been reported previously. We experienced neurilemmoma of the bronchial wall in a 72 year old woman The pulmonary radiology showed the right middle lobe collapse with single lymphadenopathy, and bronchoscopic biopsy was performed to confirm the neurilemmoma.
Aged ; Biopsy ; Extremities ; Female ; Head ; Humans ; Lymphatic Diseases ; Neck ; Neurilemmoma*

OBJECTIVE: Unilateral percutaneous vertebroplasty is a widely accepted treatment for osteoporotic vertebral compression fractures (VCFs). However, bone cement may fail to fill both hemivertebra from the single needle. We assessed the radiographic and clinical outcome of hemivertebroplasty (HVP) and evaluated the factors that affect subsequent VCFs after HVP. METHODS: Fifty two patients who underwent HVP were reviewed. VCFs were identified based on clinical and radiological findings. The patients were grouped into two groups: 1) no subsequent VCFs, 2) subsequent VCFs. We evaluated the association between age, sex, body mass index (BMI) and bone mineral density (BMD) and subsequent VCFs. We also assessed the impact of location, type and grade of fracture, endplate fracture, burst fracture, bone cement volume on subsequent VCFs. We analyzed the compression ratio, wedge angle, kyphotic angle, and visual analogue scale (VAS) score in both groups. RESULTS: There were no significant differences in age, gender, BMI, and BMD between two groups. No significant difference was also found in pre-existing VCF, location, type and grading of fracture, endplate fracture, burst fracture, amount of bone cement, and radiological findings such as compression ratio, wedge angle, and kyphotic angle between two groups. The final mean VAS scores of patients with or without subsequent VCFs were 3.11 and 4.02, respectively. CONCLUSION: No major risk factors for the subsequent VCFs after HVP were found. However, we identified adjacent fractures, refractures, and remote fractures after HVP in chronological order. Therefore, long-term follow-up is necessary to evaluate the effectiveness of HVP to osteoporotic VCFs.
Body Mass Index ; Bone Density ; Follow-Up Studies ; Fractures, Bone ; Fractures, Compression ; Humans ; Needles ; Osteoporotic Fractures ; Risk Factors ; Vertebroplasty

The effect of fermentation parameters and medium composition on the simultaneous mycelial growth and exo-polymer production from submerged cultures of Ganoderma applanatum was investigated in shake-flask cultures. The optimum initial pH for mycelial growth and exo-polymer production was 5.0 and 6.0, respectively. The optimum temperature was 25degrees C and the optimum inoculum content was 3.0% (v/v). The optimal carbon and nitrogen sources were glucose and corn steep powder, respectively. After 12 days fermentation under these conditions, the highest mycelial growth was 18.0 g/l and the highest exo-polymer production was 3.9 g/l.
Carbon ; Fermentation ; Ganoderma ; Glucose ; Hydrogen-Ion Concentration ; Nitrogen ; Zea mays

We report an unexplained anemia that persisted for 4 months in a renal transplant patient who was receiving immunosuppression therapy that included prednisolone, tacrolimus, and azathioprine. A bone marrow biopsy demonstrated pure erythroid hypoplasia and occasional giant pronormoblasts with intranuclear inclusions, characteristic of a parvovirus B19 infection. Both the serum and bone marrow cells were positive for a parvovirus B19 DNA polymerase chain reaction. The anemia resolved 6 weeks after the administration of IV immunoglobuln. But, 4 months later, refractory anemia developed and persisted despite treatment with IV immunoglobulin. However, the patient showed rapid improvement after tacrolimus was switched to cyclosporin A. A parvovirus B19 infection should be included in the differential diagnosis of renal transplant recipients who present with an anemia associated with low reticulocytes; and clinicians should be awared that tacrolimus may impair the clearance of a parvovirus B19 infection.
Anemia* ; Anemia, Refractory ; Azathioprine ; Biopsy ; Bone Marrow ; Bone Marrow Cells ; Cyclosporine ; Diagnosis, Differential ; DNA ; Erythroblasts ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Immunosuppression ; Intranuclear Inclusion Bodies ; Kidney Transplantation ; Parvovirus* ; Polymerase Chain Reaction ; Prednisolone ; Red-Cell Aplasia, Pure ; Reticulocytes ; Tacrolimus ; Transplantation

BACKGROUND: Recently, there have been reports of infections with multidrug-resistant Pseudomonas aeruginosa. To determine the mechanism of the resistance, we investigated the prevalence of Ambler class A and D beta-lactamases, their extended-spectrum derivatives, and class B and D carbapenemase in multidrug-resistant P. aeruginosa isolates. METHODS: During the period of March 2006 to May 2007, clinical isolates of multidrug-resistant P. aeruginosa were collected from patients in Chungnam National University Hospital, Daejeon, Korea. Inhibitor-potentiated disk diffusion tests were used for the screening of metallo-beta-lactamase (MBL) production. PCR and DNA sequencing were conducted for the detection of beta-lactamase genes. We also employed the enterobacterial repetitive intergenic consensus (ERIC)- PCR method for an epidemiologic study. RESULTS: A total of 37 consecutive, non-duplicate, multidrug-resistant P. aeruginosa were isolated. Twenty- nine of 37 isolates harbored blaOXA-10 (56.8%), blaOXA-2 (18.9%), and blaOXA-1 (5.4%). Only one isolate produced IMP-1, and it also harbored blaOXA-1. None harbored Ambler class A beta-lactamase or class D carbapenemase. The strains producing OXA type beta-lactamases showed a significantly higher resistance to aminoglycoside compared to non-producers. The ERIC-PCR pattern of the 19 OXA-10 producing strains indicated that the isolates were closely related in terms of clonality. CONCLUSION: OXA type beta-lactamases are the most prevalent among the acquired beta-lactamases produced by multidrug-resistant P. aeruginosa isolated at a university hospital in Chungcheong Province. Besides beta-lactam antibiotics, the strains harboring OXA type beta-lactamase showed a significantly higher resistance to aminoglycoside and qunolone.
Anti-Bacterial Agents ; Bacterial Proteins ; beta-Lactamases ; Consensus ; Diffusion ; Drug Resistance, Multiple ; Epidemiologic Studies ; Humans ; Korea ; Mass Screening ; Oxytocin ; Polymerase Chain Reaction ; Prevalence ; Pseudomonas ; Pseudomonas aeruginosa ; Sequence Analysis, DNA

OBJECTIVE: The purpose of this study was to evaluate the risk of cesarean section in nulliparous women who undergone induction at postterm pregnancy. METHODS: The retrospective study was conducted from March, 1997 to March, 2005 by reviewing 331 nulliparous patients more than 41 weeks' gestation delivered after induction at our Hospital. The evaluated variables to assess the risk of cesarean section were maternal age, body mass index (BMI), gestational age (GA), Bishop scores (BS), fetal body weight (FBW), fetal head circumference (FHC) and fetal sex. t-test and x2-test were used to compare these categorical variables. RESULTS: The study included 331 nulliparous singleton pregnant women undergoing elective induction for postterm pregnancy: 127 (38.4%) delivered babies by cesarean section due to induction failure, progression failure and fetal distress, whereas 204 (61.6%) delivered vaginally. The mean maternal ages were 27.59+/-2.57 in cesarean delivery group and 26.99+/-2.61 in vaginal delivery group. The average values of BMI at postterm in cesarean and vaginal delivery groups were 26.70+/-2.82 and 25.75+/-2.67 kg/m2. GA was 41.36+/-0.27 weeks in cesarean delivery group, whereas 41.20+/-0.19 weeks in vaginal delivery group. The average FBW and FHC were 3460.31+/-358.22 g and 34.59+/-1.18 cm in cesarean delivery group, compared to 3363.95+/-361.22 g and 34.03+/-1.34 cm in vaginal delivery group. CONCLUSION: The BMI, FBW and FHC have linked to the risk of cesarean delivery in nulliparous women who underwent elective induction. Thus, these information would provide the useful tools to assess the risk of cesarean section in postterm nulliparous patients for planning an induction.
Body Mass Index ; Cesarean Section* ; Female ; Fetal Distress ; Fetal Weight ; Gestational Age ; Head ; Humans ; Maternal Age ; Pregnancy ; Pregnancy* ; Pregnant Women ; Retrospective Studies

We experienced a case of diastasis of the symphysis pubis accompanying severe pubic pain and serious gait disturbance, which was developed at 34 weeks gestation before labor pain in 36-year-old primiparous woman, who has experienced previous cesarean section at her first pregnancy due to pelvic pain before onset of labor, so we report a case with a review of the literature.
Adult ; Cesarean Section ; Female ; Gait* ; Humans ; Labor Pain* ; Pelvic Pain ; Pregnancy

BACKGROUND: Although airway hyper-responsiveness is one of the characteristics of asthma. bronchial hyper-responsiveness has also been observed to some degree in patients with chronic obstructive pulmonary disease (COPD). Moreover, several reports have demonstrated that a number of patients have both COPD and asthma. The methacholine bronchial challenge test (MCT) is a widely used method for the detecting and quantifying the airway hyper-responsiveness, and is one of the diagnostic tools in asthma. However, the significance of MCT in differentiating asthma or COPD combined with asthma from pure COPD has not been defined. The aim of this study was to determine the role of MCT in differentiating asthma from pure COPD. METHOD: This study was performed prospectively and was composed of one hundred eleven patients who had undergone MCT at Chonbuk National University Hospital. Sixty-five asthma patients and 23 COPD patients were enrolled and their MCT data were analyzed and compared with the results of a control group. RESULT: The positive rates of MCT were 65%, 30%, and 9% in the asthma, COPD, and control groups, respectively. The mean PC20 values of the asthma, COPD, and control groups were 8.1+/-1.16 mg/mL, 16.9+/-2.21 mg/mL, and 22.0+/-1.47 mg/mL, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT for diagnosing asthma were 65%, 84%, 81%, and 69%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of MCT (ed note: please check this as I believe that these values correspond to the one PC20 value. Please check my changes.) at the new cut-off points of PC20 < or = 16 mg/ml, were 80%, 75%, 78%, and 78%, respectively. CONCLUSION: MCT using the new cut-off point can be used as a more precise and useful diagnostic tool for distinguishing asthma from pure COPD.
Asthma* ; Bronchial Provocation Tests* ; Humans ; Jeollabuk-do ; Methacholine Chloride* ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive*