Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life, but it is rare in the pleura. We recently experienced a case of cytology of malignant fibrous histiocytoma in pleural fluid. The smear revealed histiocytic malignant cells, spindle malignant cells and inflammatory cells. The histiocytic cells showed abundant, pale cytoplasm and ovoid, irregular, eccentrically-placed nuclei. The spindle cells showed elongated nuclei. Intercellular collagen was also present.
Adult ; Child* ; Collagen ; Cytoplasm ; Diagnostic Errors ; Follow-Up Studies* ; Histiocytoma, Malignant Fibrous ; Humans ; Hypercalciuria* ; Pilomatrixoma ; Pleura ; Sarcoma

No abstract available.
Paraplegia* ; Spine* ; Tuberculosis*

It is well known that the glomerular basement membrane heparan sulfate proteoglycan(GBM HSPG) synthesized by glomerular epithelial cell(GEC) has an important role in the permeability of glomerular basement membrane and cyclic AMP(cAMP) is involved in regulation of a wide variety of genes maybe including GBM HSPG gene. The direct effect of cAMP on GBM HSPG gene expression and metabolism was not evaluated as yet. Proteinuria represents an impairment of permselectivity function of glomerular basement membrane regulated by GBM HSPG and could be associated with increased glomerular level of cAMP in nephrotic syndrome of diverse causes. RPD-I(rat GBM HSPG core protein domain-I) detected a >9.5kb transcript of GBM HSPG in RNA of rat GEC. Emp1oying a riboprobe synthesized from RPD-I in RNase protection assay, we examined whether cAMP regulated perlecan expression in the GEC. At l, 6, 24 and 48 hrs of incubation, l mM cAMP caused 43%, 32%, 47% and 40% reduction in mRNA expression of perlecan, respectively. Immunoprecipitation showed a corresponding reduction of 51%, 70% and 68% in the synthesis of 35SO4 labeled GBM HSPG by the GEC fol1owing l2, 24 and 48 hrs of incubation with cAMP. Our results show that decrease in GBM HSPG gene expression and synthesis by cAMP may be of relevance to proteinuric states characterized by activation of these mediators.
Animals ; Cyclic AMP* ; Epithelial Cells* ; Gene Expression ; Glomerular Basement Membrane* ; Heparan Sulfate Proteoglycans* ; Heparitin Sulfate* ; Immunoprecipitation ; Metabolism ; Nephrotic Syndrome ; Permeability ; Proteinuria ; Rats* ; Ribonucleases ; RNA ; RNA, Messenger

Objective: : Gamma Knife radiosurgery (GKRS) is an effective and noninvasive treatment for high-risk arteriovenous malformations (AVMs). Since differences in GKRS outcomes by nidus type are unknown, this study evaluated GKRS feasibility and safety in patients with brain AVMs. Methods: : This single-center retrospective study included patients with AVM who underwent GKRS between 2008 and 2021. Patients were divided into compact- and diffuse-type groups according to nidus characteristics. We excluded patients who performed GKRS and did not follow-up evaluation with magnetic resonance imaging or digital subtraction angiography within 36 months from the study. We used univariate and multivariate analyses to characterize associations of nidus type with obliteration rate and GKRS-related complications. Results: : We enrolled 154 patients (mean age, 32.14±17.17 years; mean post-GKRS follow-up, 52.10±33.67 months) of whom 131 (85.1%) had compact- and 23 (14.9%) diffuse-type nidus AVMs. Of all AVMs, 89 (57.8%) were unruptured, and 65 (42.2%) had ruptured. The mean Spetzler-Martin AVM grades were 2.03±0.95 and 3.39±1.23 for the compact- and diffuse-type groups, respectively (p<0.001). During the follow-up period, AVM-related hemorrhages occurred in four individuals (2.6%), three of whom had compact nidi. Substantial radiation-induced changes and cyst formation were observed in 21 (13.6%) and one patient (0.6%), respectively. The AVM complete obliteration rate was 46.1% across both groups. Post-GKRS complication and complete obliteration rates were not significantly different between nidus types. For diffuse-type nidus AVMs, larger AVM size and volume (p<0.001), lower radiation dose (p<0.001), eloquent area location (p=0.015), and higher Spetzler-Martin grade (p<0.001) were observed. Conclusion : GKRS is a safe and feasible treatment for brain AVMs characterized by both diffuse- and compact-type nidi.

We experienced a case of non-Hodgkin's lymphoma presented only as right side pleural effusion, that is primary effusion lymphoma (PEL), in a 75 year-old male patient in Korea where is the endemic area of tuberculosis. He visited our hospital complaining of exertional dyspnea. He did not have B symptoms. The breathing sound was decreased on the right side chest, but we could not find external lymphadenopathy or hepatosplenomegaly on physical examination. Simple chest radiograph showed right side pleural effusion. The cells of pleural fluid were lymphocyte-predominant and the pH, protein, lactate dehydrogenase, adenosine deaminase of the fluid was 7.31, 38 g/L, 381 U/L, 31 U/L, respectively. The biopsy specimen of the parietal pleura was diagnosed as non-Hodgkin's lymphoma of small lymphocytic type. Computed tomograph of the chest, abdomen and pelvis, and the biopsy of bone marrow were negative for disease. We tried up to 3 cycles of chemotherapy with adriamycin, vincristine, cyclophosphamide and prednisolone and there was a marked decrease in the amount of the pleural effusion.
Abdomen ; Adenosine Deaminase ; Aged ; Biopsy ; Bone Marrow ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Dyspnea ; Humans ; Hydrogen-Ion Concentration ; Korea ; L-Lactate Dehydrogenase ; Lymphatic Diseases ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Lymphoma, Primary Effusion ; Male ; Pelvis ; Physical Examination ; Pleura ; Pleural Effusion* ; Prednisolone ; Radiography, Thoracic ; Respiratory Sounds ; Thorax ; Tuberculosis ; Vincristine

Marfan syndrome is an inheritable connective tissue with protean clinical manifestations involving the ocular, skeletal and cardiovascular system. It is well estabalished that a clinical hall marker and the major cause of morbidity in Marfan syndrome is aortic root dilatation and associated aortic dissection which begins just above the coronary ostia in ascending aorta. We report a rare case of Marfan syndrome with aortic dissection which began just below left subclavian artery in descending aorta. A 20-years old woman was admitted to Soonchunhyang hospital because of sudden onset of back pain. On phsical examination, she had characteristic Marfanoid feature. Chest X-ray and Echocardiography showed cardiomegaly and severe dilatation of ascending aorta. Chest CT and aortography showed severe aneurysm of ascending aorta and aortic dissection of descending aorta with intimal flap. she was treated with medical treatment because of poor general condition.
Aneurysm ; Aorta ; Aorta, Abdominal* ; Aorta, Thoracic ; Aortic Aneurysm* ; Aortography ; Back Pain ; Cardiomegaly ; Cardiovascular System ; Connective Tissue ; Dilatation ; Echocardiography ; Female ; Humans ; Marfan Syndrome* ; Subclavian Artery ; Thorax ; Tomography, X-Ray Computed ; Young Adult

Marfan syndrome is an inheritable connective tissue with protean clinical manifestations involving the ocular, skeletal and cardiovascular system. It is well estabalished that a clinical hall marker and the major cause of morbidity in Marfan syndrome is aortic root dilatation and associated aortic dissection which begins just above the coronary ostia in ascending aorta. We report a rare case of Marfan syndrome with aortic dissection which began just below left subclavian artery in descending aorta. A 20-years old woman was admitted to Soonchunhyang hospital because of sudden onset of back pain. On phsical examination, she had characteristic Marfanoid feature. Chest X-ray and Echocardiography showed cardiomegaly and severe dilatation of ascending aorta. Chest CT and aortography showed severe aneurysm of ascending aorta and aortic dissection of descending aorta with intimal flap. she was treated with medical treatment because of poor general condition.
Aneurysm ; Aorta ; Aorta, Abdominal* ; Aorta, Thoracic ; Aortic Aneurysm* ; Aortography ; Back Pain ; Cardiomegaly ; Cardiovascular System ; Connective Tissue ; Dilatation ; Echocardiography ; Female ; Humans ; Marfan Syndrome* ; Subclavian Artery ; Thorax ; Tomography, X-Ray Computed ; Young Adult

BACKGROUND: NSAIDs (Nonsteroidal antiinflammatory drugs) had been known as having analgesic property and its mechanism is prostaglandin synthesis blocking action -peripheral mechanism-. Nowadays, central mechanism of NSAIDs were postulated by some animal or clinical studies, but the preemptive analgesic effects have been still in controversy. Thus, authors planned this study to evaluate whether NSAIDs have the preemptive analgesic effect by using propacetamol and ketorolac. METHODS: Seventy five patients undergoing laparoscopic vaginal hysterectomy were subjected and randomly allocated into three groups according to drugs given. Group P (n=25) and group K (n=25) were given propacetamol 2 gm or ketorolac 30 mg intravenous respectively at 15 minutes before induction. Group C (n=25) had no medication. Pain control using morphine were started in all three groups before skin incision. One anesthesiologist who didn't know which group the patients were allocated visited the patients when the patient arrived at recovery room after operation, postoperative 1 hour, 6 hours, 12 hours, 24 hours and 48 hours and estimated pain score and side effects. Parameters using pain score were visual analogue score (VAS; 100 mm) -subjective parameter- and Prince-Henry score (PHS) -objective parameter-. If VAS>50 or PHS>3, morphine 2.5 mg were given by i.v. and pain score were reestimated after 5 minutes and same dose of morphine were given until VAS<50 and PHS<3. RESULTS: Demographic data of three groups were insignificant. In group P, lower VAS, PHS and morphine consumption were observed than the other groups. Significant changes according to time were observed until postoperative 6 hours in each groups. Side effects occurred as nausea, vomiting and somnolence but statistical significance between groups were absent. CONCLUSIONS: Preoperative i.v. administration of propacetamol 2 gm in laparoscopic vaginal hysterectomy could have preemptive analgesic effects. But we think that determining the proper dosage and timing of administration that could have preemptive analgesic effect of NSAIDs are subjects demands further study.
Animals ; Anti-Inflammatory Agents, Non-Steroidal* ; Female ; Humans ; Hydrogen-Ion Concentration ; Hysterectomy, Vaginal ; Ketorolac ; Morphine* ; Nausea ; Recovery Room ; Skin ; Vomiting

BACKGROUND: Although the pro-convulsant or anticonvulsant properties of propofol remain a matter of controversy, it is evident that propofol can produce involuntary movement. Such movement is a relatively common side effect, especially in children, and may be dose-related or injection rate-related. The goal of this study was to evaluate the effect of injection rate upon involuntary movement during propofol induction in children. METHODS: Children (age 3-14 yr) undergoing elective Eye and ENT surgery were randomly allocated to one of 4 groups based on the propofol injection rate (A, manual/15 s; B, 360 ml/hr; C, 200 ml/hr, D, 100 ml/hr) using a manual injection method and syringe pumps. No premedication was used. The induction dosage of propofol was 3 mg/kg in all groups. Fentanyl 1mcg/kg and 1% lidocaine 1-2ml were given I.V. before propofol. Involuntary movement was graded 0-2 on severity. The infused dose of propofol at movement was measured. Movement due to pain or mask fitting was not regarded as an involuntary movement. All results were analyzed using the Chi-Square Test and ANOVA. RESULTS: 595 children were studied. Age, gender, and weight were similar in the 4 groups. Involuntary movements were apparent in 179 (30.1%) of the 595 subjects. Movements were significantly less in group A (12.4%) and B (16.4%) compared to group C (46.6%) and D (45.3%). The grades of movement were not different among the 4 groups. The durations of movement in group A and B were significantly short compared to group C and D. The infused dose of propofol (mg/kg) at movement was higher in group C (2.65+/-0.62) than in A (1.99+/-0.62) and B (2.43+/-0.78). There were no significant hemodynamic and SPO2 changes during and after the propofol injection. CONCLUSIONS: We concluded that slow injection may increase the incidence of involuntary movement during propofol induction in children. Since the bolus injection rates are usually slow in most syringe pumps, manual injection for 10 15 s may be a better choice for smoother induction, as it requires fewer interventions to prevent venous catheter displacement in children.
Catheters ; Child* ; Dyskinesias* ; Fentanyl ; Hemodynamics ; Humans ; Incidence ; Lidocaine ; Masks ; Premedication ; Propofol* ; Syringes

Actinomycosis is a chronic suppurative and granulomatous disease caused by Actinomyces species and characterized by sulfur granule formation. Depending on the site of primary infection, it is generally classified as cervicofacial, thoracic and abdominal type. Abdominal actinomycosis is often difficult to diagnose before operation because of low frequency and no characteristic clinical features of the disease. As it progresses chronically, it can be misdiagnosed such as cancer, inflammatory bowel disease or other abscess. The diagnosis is usually based on histologic demonstration of sulfur granules in pus or surgically resected specimen. In vast majority of cases, treatment has consisted of long-term antibiotic therapy coupled with surgical resection. We experienced a case of colonic actinomycosis initially diagnosed as Dieulafoy's ulcer and confirmed by colonoscopic biopsy. Treatment with intravenous penicillin for 4 weeks was successful independently, and we report this case with a brief review of literatures.
Abscess ; Actinomyces ; Actinomycosis* ; Biopsy ; Colon ; Colonoscopy ; Diagnosis ; Inflammatory Bowel Diseases ; Penicillins ; Sulfur ; Suppuration ; Ulcer*