Osteosarcoma in soft tissue is rare and its prognosis is very grave. Comparing with the osteosarcoma of bone, the former is rarer in incidence, poorer in prognosis and found in older patients. Trauma, irradiation or myositis ossificans are considered to be the causes of this tumor. The radical and meticulous surgery is indispensable to eradicate the focus, but there is not infrequent local recurrence and metastasis. We experienced a case of osteosarcoma in the calf muscle, which seemed apparently to have developed from the myositis ossificans without any definite trauma history. In this case the tumor focus was controlled with surgery and radiation therapy but it was found metastasized to the lung and scalp afterwards.
Humans ; Incidence ; Lung ; Myositis Ossificans ; Neoplasm Metastasis ; Osteosarcoma ; Prognosis ; Recurrence ; Scalp

BACKGROUND: Enterococci exhibit intrinsic resistance or high-level minimum inhibitory concentration (MIC) to beta-lactams than other streptococci. This appears to be due to low affinity of penicillin-binding proteins and rarely production of beta-lactamase, which gives the reason of testing beta-lactamase for blood and cerebrospinal fluid isolates. Ampicillin is more effective than penicillin in vitro, and MIC of ampicillin is generally 1 dilution lower than that of penicillin. The purpose of this study is to detect beta-lactamase producing enterococci an6 to compare MICs of ampicillin and penicillin by Vitek system (bioMerieux, Hazelwood, MO, USA) with those by agar dilution method. METHODS: We collected 110 isolates of Enterococcus faecalis and 51 isolates of E. faecium from clinical specimens in 1998. MICs of antibiotics were determined by agar dilution method and Vitek system. We also performed beta-lactamase test by the Cefinase (Becton Dickinson, USA) for 512 isolates of E. faecalis and 189 isolates of E. faecium collected in 1998. RESULTS: The most common sites of isolates were blood, bile, surgical/traumatic wounds, closed and open pus and urine. MICs of ampicillin were 1 to 2 dilution lower than those of penicillin for E. faecalis (P=0.03). But there were no significant differences in MICs for E. faecium (P=0.19). Five isolates (4 E. faecalis and 1 E. faecium) were susceptible to ampicillin but resistant to penicillin. There were no beta-lactamase producing enterococci among 701 isolates tested. CONCLUSIONS: MIC by Vitek system tends to be 1 to 2 dilution lower than MIC by agar dilution method to beta-lactams, and MIC of ampicillin is 1 to 2 dilution lower than MIC of penicillin, which could result in discrepancy in interpretation of susceptibilty tests. A beta-lactamase test for enterococci is not recommeneded for routine test in Korea.
Agar ; Ampicillin ; Anti-Bacterial Agents* ; beta-Lactamases ; beta-Lactams ; Bile ; Cerebrospinal Fluid ; Enterococcus faecalis ; Enterococcus* ; Korea ; Microbial Sensitivity Tests ; Penicillin-Binding Proteins ; Penicillins ; Suppuration ; Wounds and Injuries

The experiment was performed to investigate changes of maternal immune status during the pregnancy. We observed the distribution of several immune cells [macrophage, activated B-cell, IgM+ B-cell, Lyt-2+ T-cell and L3T4+ T-cells] in the utero-placental interface and the peripheral blood of Balb/c mice. The experimental animals were divided into seven groups by the gestational ages ; virgin, 2nd, 5th, 8th, 10th, 14th and 19th day of pregnancy. In the utero-placental interface, the distribution patterns of the lymphocytes [both T and B] and macrophages were observed. Histochemical staining by naphthol-AS-MX phosphate sodium salt was used for the detection of activated B-cells. For the detection of macrophage, plasma cell, suppressor cell and helper cell, all the prepared samples reacted with Rat anti-mouse Mac-1, goat anti-mouse IgM, rat anti-Lyt2 and rat anti-L3T4 antibody first, and washed. Second reaction was done with biotinylated anti-rat or anti-mouse IgG anti-bodies, and washed. Avidin-biotin -peroxidase complex and 3, 3`-diamino-benzidine[DAB] were used for the visualization of specific cells. T-cells and B-cells were not observed during the all stages of pregnancy. By contrast, macrophages were observed a few at the perimetrium on the second day of gestation, and they were found at the outermost portion of the trophoblastic layer on the 8th day, and they were observed at the decidua basalis in late pregnancy after the 10th day when the placenta were well developed. In the peripheral blood, activated B-cells were not observed throughout the pregnancy. On the 8th day, the proportion of plasma cells to total mononuclear cells was decreased significantly to 16+/-2.4% compared with the virgin group[22+/-2.6%][p<0.01]. It increased again and it reached 42+/-5.8% on the 14th day and 37+/-4.9% on the 19th day. Helper T-cells were decreased on the 14th day[30+/-2.4%] compared with the normal control[47+/-5.1%]. But, Suppressor T-cells were increased on the 8th day[35+/-2.9%] and the 10th day[33+/-3.6%] compared with the normal controls[27+/-2.3%]. This decrement returned to the level of the normal controls on the 14th day and 19th day. Together with our previous data, we could find the synchronized changes of immune cells in utero-placental interface, uterus draining lymph nodes, peripheral blood and spleen. Therefore, we suggest that macrophages in utero-placental interface may play an important role for the immune responses against the fetal transplantation antigen.
Animals ; B-Lymphocytes* ; Decidua ; Female ; Gestational Age ; Goats ; Immunoglobulin G ; Immunoglobulin M ; Lymph Nodes ; Lymphocytes ; Macrophages* ; Mice* ; Placenta ; Plasma Cells ; Pregnancy ; Rats ; Sodium ; Spleen ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Trophoblasts ; Uterus

BACKGROUND: Early detection and treatment of cytomegalovirus (CMV) infection is very important because CMN infection is a major cause of morbidity and mortality after organ transplantation. CMV antigenemia assay has been reported to be very sensitive and specific for detection of CMV infection among many laboratory methods. However, there is no single method correlated well with the infection state up to now. We compared the results of SHARP Signal System Assay (Digene, USA) using PCR and hybridization with those of CMV antigenemia assay (Clonab CMV-kit; Biotest AG, Germany) to evaluate their clinical usefulness. METHODS: We performed SHARP Signal Assay on whole blood samples of 125 from 56 transplanted patients submitted for CMV antigenemia at Samsung Medical Center. We compared the results with those of CMV antigenemia and evaluated the correlation with CMV disease state. RESULTS: Fifty six patients were classified as three groups; 43 patients with no evidence of CMV infection, four patients with CMV infection and 9 patients with CMV disease. Twenty four cases (19.2%) showed discrepant results between the two methods. Of the 22 cases showing positive only by SHARP Signal Assay, two cases were proved to be CMV disease, 12 cases were on antiviral treatment and remaining cases had no evidence of infection. Two cases showing positive only by CMV antigenemia were confirmed to be CMV disease. For CMV disease, the sensitivity of SHARP Signal Assay and CMV antigenemia were 85.7% and 90.5%, respectively and the specificity of them were 73.1% and 93.3%, respectively. CONCLUSIONS: CMV antigenemia is thought to be useful for early diagnosis and follow-up of antiviral treatment as a quantitative and highly specific method, and SHARP Signal Assay can be used as a complementary method because it correlates well with disease state.
Cytomegalovirus Infections* ; Cytomegalovirus* ; Diagnosis* ; Early Diagnosis ; Follow-Up Studies ; Humans ; Mortality ; Organ Transplantation ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Transplants

A case of sacrococcygeal chordoma diagnosed by fine needle aspiration is presented. This is a case of a 54-year-old woman who came with coccygeal pain of 5-6 months duration. Aspiration biopsy cytology revealed many nests of cells having abundant bubbly cytoplasm and round to oval variably sized nuclei. The cells had indistinct cytoplasmic borders and many of the cells had cytoplasmic vacuoles. The nuclei had thin regular nuclear membranes, finely granular chromatin and one or two small nucleoli. The cells were generally monotonous, but focally pleomorphic with giant cell formation. Mitotic figures were scanty. The backgroud of the aspirate contained abundant mucinous materal. These findings were typical of those of recorded chordoma cases and the diagnosis was confirmed by a following open biopsy. The patient received 4,000 rads of neutron radiotherapy and has been well till March '88.
Female ; Humans ; Biopsy

Fine needle aspiration cytologic findings of four cases of chondrosarcoma were described. The cases consisted of one primary scapular tumor, two recurrent shoulder masses, and right upper quadrant mass which developed after an A-K amputation for an unknown tumor. The aspirates characteristically revealed cell-rich smears containing clusters and isolated cells having abundant cyanophilic cytoplasm and round to oval or elongated vesicular nuclei. The cytoplasm was occasionally foamy. The nuclei were usually small but prominent. Nuclear atypism and pleomorphism were frequently associated. The last case showed epithelioid sheets of polygonal cells, possibly representing chondroblasts, and a well differentiated chondroid element. The fine needle aspiration could be a good diagnostic tool for primary, recurrent, and metastatic chondrosarcomas.
Neoplasm Metastasis

Fine needle aspiration cytologic findings of four cases of chondrosarcoma were described. The cases consisted of one primary scapular tumor, two recurrent shoulder masses, and right upper quadrant mass which developed after an A-K amputation for an unknown tumor. The aspirates characteristically revealed cell-rich smears containing clusters and isolated cells having abundant cyanophilic cytoplasm and round to oval or elongated vesicular nuclei. The cytoplasm was occasionally foamy. The nuclei were usually small but prominent. Nuclear atypism and pleomorphism were frequently associated. The last case showed epithelioid sheets of polygonal cells, possibly representing chondroblasts, and a well differentiated chondroid element. The fine needle aspiration could be a good diagnostic tool for primary, recurrent, and metastatic chondrosarcomas.
Neoplasm Metastasis

No abstract available.
Down Syndrome*

No abstract available.
Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Fracture Fixation, Intramedullary*

OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans