Blunt chest trauma may cause a variety of cardiac injuries, such as cardiac contusion, congestive heart failure due to myocardial injury or disruption of intracardiac structures, and more severely, instantaneous death. Traumatic rupture of the interventricular septum secondary to blunt chest trauma is extremely rare. Rupture of the interventricular septum may occur almost immediately after injury or many days later. The most common site of rupture is in the muscular portion of the septum near the apex. The exact mechanism of ventricular septal rupture in blunt trauma is unknown but it is thought to occur by external compression of the heart between the sternum and the vertebrae or as a result of extreme changes in intrathoracic pressure during sudden deceleration. We report an autopsy case of intraventricular septum rupture due to blunt chest trauma. A comatous 28-year-old male was admitted to emergency room after blunt chest trauma by unidentified object. He was treated with supportive care but expired two days later. The autopsy findings were as follows. The dead boy was slightly slender. External wound and patterned bruise were not present. In submentopubic incision, both pleural fluid (right 700ml, left 450ml) and ascites (400ml) were noted. The posterior wall of left ventricle showed hemorrhage measuring 1cm in diameter. On opening the heart, there was interventricular septum rupture measuring 3.5cm in length. Other cardiac structures were unremarkable. On light microscopic examination, endothelial cell was not seen in ruptured portion and both lung showed severe congestion and edema.
Adult ; Ascites ; Autopsy ; Contusions ; Deceleration ; Edema ; Emergency Service, Hospital ; Endothelial Cells ; Estrogens, Conjugated (USP) ; Heart ; Heart Failure ; Heart Ventricles ; Hemorrhage ; Humans ; Lung ; Male ; Rupture* ; Spine ; Sternum ; Thorax* ; Ventricular Septal Rupture ; Wounds and Injuries

Blunt chest trauma may cause a variety of cardiac injuries, such as cardiac contusion, congestive heart failure due to myocardial injury or disruption of intracardiac structures, and more severely, instantaneous death. Traumatic rupture of the interventricular septum secondary to blunt chest trauma is extremely rare. Rupture of the interventricular septum may occur almost immediately after injury or many days later. The most common site of rupture is in the muscular portion of the septum near the apex. The exact mechanism of ventricular septal rupture in blunt trauma is unknown but it is thought to occur by external compression of the heart between the sternum and the vertebrae or as a result of extreme changes in intrathoracic pressure during sudden deceleration. We report an autopsy case of intraventricular septum rupture due to blunt chest trauma. A comatous 28-year-old male was admitted to emergency room after blunt chest trauma by unidentified object. He was treated with supportive care but expired two days later. The autopsy findings were as follows. The dead boy was slightly slender. External wound and patterned bruise were not present. In submentopubic incision, both pleural fluid (right 700ml, left 450ml) and ascites (400ml) were noted. The posterior wall of left ventricle showed hemorrhage measuring 1cm in diameter. On opening the heart, there was interventricular septum rupture measuring 3.5cm in length. Other cardiac structures were unremarkable. On light microscopic examination, endothelial cell was not seen in ruptured portion and both lung showed severe congestion and edema.
Adult ; Ascites ; Autopsy ; Contusions ; Deceleration ; Edema ; Emergency Service, Hospital ; Endothelial Cells ; Estrogens, Conjugated (USP) ; Heart ; Heart Failure ; Heart Ventricles ; Hemorrhage ; Humans ; Lung ; Male ; Rupture* ; Spine ; Sternum ; Thorax* ; Ventricular Septal Rupture ; Wounds and Injuries

Sjogren's syndrome (SS) is an autoimmune disorder in which lymphocytes infiltrate the exocrine glands, resulting in the development of sicca symptoms. Lymphocytes may also invade various other organs and cause diverse symptoms. Interstitial pneumonia has been observed frequently in SS patients. Typically, the pneumonia responds well to systemic steroids, and fatal cases are rare. We experienced a case of lymphocytic pneumonia accompanied by SS and treated with cyclophosphamide pulse therapy, and we present details of the case herein.
Adult ; Humans ; Lung/*pathology ; Lung Diseases, Interstitial/drug therapy/*pathology ; Lymphocytes/*pathology ; Male ; Plasma Cells/pathology ; Sjogren's Syndrome/*pathology

BACKGROUND: The relationship between bile duct proliferation and portal fibrosis in obstructive liver diseases remains unclear. The purpose of this study is to analyze the relationship between hepatic stellate cells (HSC), hepatocytes and bile ductule proliferation in obstructive liver disease using immunoreactivity for alpha-SMA (alpha-smooth muscle actin), CK7, and CK19. METHODS: We used 20 human tissue samples with hepatic fibrosis due to intrahepatic stones and liver cirrhosis. Immunohistochemical staining was performed using the streptavidin-biotin method. RESULTS: Proliferations of bile ductules at the periphery of the hepatic lobules, and diffuse HSC activation in the perisinusoidal spaces were observed in all cases. Immunoreactivity of the hepatocytes for CK7 and CK19 suggested a possible phenotypic transformation into bile duct epithelium during fibrogenesis. Immunohistochemical-analyses of alpha-SMA expression profiles showed that intralobular HSCs and some hepatocytes underwent early phenotypic changes, and that the accumulation of collagen coincides with that of alpha-SMA-labeled myofibroblasts around portal/septal ductular structures. CONCLUSIONS: Our results showed the possibility of a phenotypic transformation of hepatocytes into bile ductular epithelium. It is suggested that hepatocytes might play a role in bile ductule proliferation in obstructive liver disease.
Bile ; Bile Ducts ; Collagen ; Epithelium ; Fibrosis ; Hepatic Stellate Cells ; Hepatocytes ; Humans ; Liver ; Liver Cirrhosis ; Liver Diseases ; Muscles ; Myofibroblasts

Among 136 patients having undergone mitral valve surgery from September of 1994 through August of 1995 in Sejong Heart Institute, forty four patients(18 males, 26 females) underwent mitral valve reconstruction using prosthetic rings and their clinical results were evaluated. Patients' ages ranged from 5 to 63 years(mean age 38.2 years). Mitral valvular diseases were due to rheumatic origin in 30 patients(68 %), degenerative in 13(30%), and congenital in one patient(2%). Mitral regurgitation(MR) was in 33 patients(76%), mitral stenosis 2(5%), and mitral stenoinsufficiency 9 patients(19%). The patients were divided into Carpentier's functional groups : type I, 5 patients(11%) ; type II, 24 patients(55%) ; type III, 4 patients (9%) ; and mixed(II + III), 11 patients(25%). Average number of anatomic lesions of mitral valve per patient was 3.7. The techniques included prosthetic ring annuloplasty(44 patients, 32 Carpentier ring and 12 Duran ring), leaflet mobilization(24, 55%), chordae shortening(23, 52%), chordae trans- position(23, 52%), commissurotomy(16, 35%), leaflet resection(9, 20%), papillary muscle splitting(8, 18%), and chordae reimplantation(1, 2%). Average 3.4 surgical procedures were applied on mitral valve per patient. There were two hospital mortality and one reoperation due to development of MR(grade III) after 2 weeks. During the mean follow up of 12 months, patients improved in terms of functional class of the New York Heart Association, which was mean 3.0 preoperatively and 1.3 postoperatively. Doppler echocardiographic studies showed adequate valve area(2.07 +/- 0.11 cm2, mean +/- standard error), improved ventricular contractility in 41 patients(93%), absence of MR in 23(53%), trace MR in 18(42%), and grade II MR in 2 patients(5%).
Echocardiography ; Follow-Up Studies ; Heart ; Heart Valve Diseases* ; Hospital Mortality ; Humans ; Male ; Mitral Valve ; Mitral Valve Annuloplasty ; Mitral Valve Stenosis ; Papillary Muscles ; Reoperation

Sarcoidosis is a systemic granulomatous inflammation with an unknown cause. The commonly involved sites are the lymph nodes, lungs, skin, eyes, and heart. Although cardiac involvement in sarcoidosis is rarely detected clinically, it is reported in 20-50% of autopsied sarcoidosis patients. Cardiac involvement is one of the most severe conditions of sarcoidosis and may cause sudden death. We report a case of a sudden death due to a massive cardiac sarcoidosis in a 43-year-old man. The microscopic examination revealed an extensive noncaseating granulomatous inflammation in the mediastinal lymph nodes and the heart with no evidence of myocyte necrosis. A special stain and molecular study excluded the possibility of other causes such as fungi or mycobacterium. The authors concluded that the cause of death was attributed to arrhythmia due to a cardiac sarcoidosis with massive involvement of the conduction system.
Adult ; Arrhythmias, Cardiac ; Cause of Death ; Death, Sudden* ; Death, Sudden, Cardiac ; Fungi ; Heart ; Humans ; Inflammation ; Lung ; Lymph Nodes ; Muscle Cells ; Mycobacterium ; Necrosis ; Sarcoidosis* ; Skin

Solitary myofibroma is a recently described, benign neoplasm of superficial soft tissue, which represents the adult counterpart of infantile myofibromatosis. In Korean literature, only one case has been reported, and we report an additional case of solitary myofibroma in a 57-year-old man. He presented with 2-month history of asymptomatic slightly elevated pale-skin-colored nodule occurring on the right side of philtrum. A histopathologic examination revealed diffuse proliferation of fibroblasts and spindle cells with a whorled arrangement and grouped fascicles. The tumor cells were positively stained for vimentin and smooth muscle actin.
Actins ; Adult* ; Fibroblasts ; Humans ; Immunohistochemistry ; Lip ; Middle Aged ; Muscle, Smooth ; Myofibroma* ; Myofibromatosis ; Vimentin

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare T-cell lymphoma characterized by involvement of the subcutaneous tissue of neoplastic T lymphocytes. SPTCL with hemophagocytic syndrome (HPS) is associated with an aggressive clinical course and treatment of SPTCL with HPS is not well established. Cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP) therapy is not successful in most patients suffering from SPTCL with HPS. The role of high dose chemotherapy followed by hematopoietic stem cell transplantation (HSCT) remains controversial. We report a case of relapsed SPTCL after CHOP chemotherapy and salvage chemotherapy followed by autologous HSCT, which had rapid improvement within weeks after cyclosporine and prednisolone. Immunosuppressive therapy may be an important and successful treatment option in SPTCL patients, even though they may have clinically aggressive disease.
Cyclophosphamide ; Cyclosporine ; Doxorubicin ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma ; Lymphoma, T-Cell ; Panniculitis ; Prednisolone ; Stress, Psychological ; Subcutaneous Tissue ; T-Lymphocytes ; Vincristine

Primary retroperitoneal mucinous cystadenocarcinoma is a rare tumor. Only about 30 such cases have been reported in the worldwide literature, and a few Korean cases have been reported. The pathogenesis is not clear, and coelomic metaplasia of the retroperitoneal mesothelium has gained wide support. There is no consensus on the appropriate treatment, but surgical exploration is needed for the diagnosis and treatment, and adjuvant chemotherapy may be recommended following complete surgical excision. The long-term prognosis has not been established. We report here on a 32-year-old woman who was diagnosed as having a retroperitoneal mucinous cystadenocarcinoma with mural nodules of sarcomatoid change. Tumor excision and adjuvant chemotherapy were done and the patient is doing well without any evidence of recurrence at 42 months postoperatively.
Adult ; Cystadenocarcinoma, Mucinous/*diagnosis/pathology/surgery ; Female ; Humans ; Retroperitoneal Neoplasms/*diagnosis/pathology/surgery

BACKGROUND: AND PURPOSE: The aim of this study was to determine the diagnostic performance and safety of a new ¹⁸F-labeled amyloid tracer, ¹⁸F-FC119S. METHODS: This study prospectively recruited 105 participants, comprising 53 with Alzheimer's disease (AD) patients, 16 patients with dementia other than AD (non-AD), and 36 healthy controls (HCs). In the first screening visit, the Seoul Neuropsychological Screening Battery cognitive function test was given to the dementia group, while HC subjects completed the Korean version of the Mini Mental State Examination. Individuals underwent ¹⁸F-FC119S PET, ¹⁸F-fluorodeoxyglucose (FDG) PET, and brain MRI. The diagnostic performance of ¹⁸F-FC119S PET for AD was compared to a historical control (comprising previously reported and currently used amyloid-beta PET agents), ¹⁸F-FDG PET, and MRI. The standardized uptake value (SUV) ratio (ratio of the cerebral cortical SUV to the cerebellar SUV) was measured for each PET data set to provide semiquantitative analysis. All adverse effects during the clinical trial periods were monitored. RESULTS: Visual assessments of the ¹⁸F-FC119S PET data revealed a sensitivity of 92% and a specificity of 84% in detecting AD. ¹⁸F-FC119S PET demonstrated equivalent or better diagnostic performance for AD detection than the historical control, ¹⁸F-FDG PET (sensitivity of 80.0% and specificity of 76.0%), and MRI (sensitivity of 98.0% and specificity of 50.0%). The SUV ratios differed significantly between AD patients and the other groups, at 1.44±0.17 (mean±SD) for AD, 1.24±0.09 for non-AD, and 1.21±0.08 for HC. No clinically significant adverse effects occurred during the trial periods. CONCLUSIONS ¹⁸F-FC119S PET provides high sensitivity and specificity in detecting AD and therefore may be considered a useful diagnostic tool for AD.