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

Tracheoesophageal fistula (TEF) is a rare disease, which develops as a result of congenital or acquired causes. Moreover, TEF can be caused by an overinflated cuff during respiratory care with a ventilator in the ICU. So, a low pressure high volume cuff is being used to prevent injury of the tracheal mucosa by the endotracheal tube. The use of a low pressure high volume cuff has decreased respiratory complications, but TEF is still being reported. This case concerns a 78-year-olds woman with heart failure. She was hospitalized for hemiarthroplasty because of a right femur fracture. On the day after admission, she had apnea due to heart failure, but recovered on receiving respiratory care by using a ventilator in the ICU. Thereafter, she began to show symptoms such as paroxysmal coughing, vomiting, and aspiration. We investigated using computed tomography, bronchoscopy and esophagography. We observed a 2-3 cm sized fistula along the posterior wall of the trachea. It was located about 10 cm upper side from the carina on bronchoscopy, perfomed was found in the ICU. She was found to have a TEF and was treated surgically. After her symptoms had improved, she was given hemiarthroplasty under epidural anesthesia. However, 4 days after the operation, the TEF relapsed, but was not as severe as it had been previously. She was alert, but ambulation was not possible because of a general weakness due to long-term hospitalization. Even with the danger of aspiration pneumonia, she left the hospital upon her guardian's request. We report upon this clinical experience and include a brief review of the literature.
Aged ; Anesthesia, Epidural ; Apnea ; Bronchoscopy ; Cough ; Female ; Femur ; Fistula ; Heart Failure ; Hemiarthroplasty ; Hospitalization ; Humans ; Mucous Membrane ; Pneumonia, Aspiration ; Rare Diseases ; Trachea ; Tracheoesophageal Fistula* ; Ventilators, Mechanical ; Vomiting ; Walking

Leiomyoma may originate at any anatomic location of smooth muscle in the genitourinary system. The kidney capsule is the most common site for the genitourinary leiomyomas. Leiomyoma origination from the scrotum is rare. The previous reported cases presented as small, firm, nontender, slowly enlarging freely movable masses within the scrotum. We report a case of leiomyoma of the tunica dartos, a benign lesion arising from the wall of the left scrotum. It presented as a pedunculated lesion with a surface ulceration, which need to be differentiated from squamous carcinoma of the scrotum. It was treated with a simple surgical excision.
Carcinoma, Squamous Cell/pathology ; Diagnosis, Differential ; Genital Neoplasms, Male/*pathology ; Humans ; Leiomyoma/*pathology ; Male ; Middle Aged ; *Scrotum

Juvenile nasophayngeal angiofibroma (JNA) is a histologically benign but highly vascular, agressively expansile lesion that occurs exclusively in prepubescent or pubescent males. Traditional treatmemt strategy of JNA has included open surgical approaches for majority of tumors. However, radiosurgery has been rarely applied for juvenile nasopharyngeal angiofibroma (JNA) and cumulative reports are lacking. The authors report a case of successful treatment of postoperative residual JNA with gamma knife radiosurgery.
Angiofibroma ; Humans ; Male ; Radiosurgery