Necrotizing lymphadenitis was first recognised as a self-limiting lymphadenitis by Japanese workers in 1972. It is a distinct clinicopathologic entity, but can be mistaken as malignant lymphoma. We have studied clinicopathologic features in 15 cases of necrotizing lymphadenitis. This disease occurs predominantly in young adult. Male-female ratio is 2 : 1. The commonest presentation is lateral cervical lymphadenopathy. Pain, tenderness, and fever can be seen. Biopsy of the lymph nodes from all patients demonstrates the characteristic histologic features : multifocal, relatively circumscribed nodules in the cortex and/or paracortex, consisting of a mixture of activated large lymphoid cells, histiocytes and Small lymphocytes. Numerous karyorrhetic debris are present. Neutrophils and plasma cells are strikingly absent.
Asian Continental Ancestry Group ; Biopsy ; Fever ; Histiocytes ; Humans ; Lymph Nodes ; Lymphadenitis* ; Lymphatic Diseases ; Lymphocytes ; Lymphoma ; Neutrophils ; Plasma Cells ; Young Adult

In order to define the relation between echocardiographically determined left atrial size and atrial fibrillation(AF) in rheumatic mitral valvular heart disease, 44 patients with mitral valvular heart disease with AF, 29 patients with mitral valvular heart disease without AF, 24 patients with idiopathic AF and 24 normal controls were studied. In mitral valvular heart disease with AF group, AF was more common when the absolute left atrial internal diameter(LAID) was above 50 mm(86.4%) than in mitral valvular heart disease without AF group(41.4%). In addition, although the values of LAID, LA(left atrium)/Aortic Root ratio and LA/BSA(body surface area) are higher in mitral valvular heart disease with AF group than in mitral valvular heart disease without AF group(p<0.05), there was no correlation between LAID and BSA(r=0.06). These findings suggest that an absolute value of LAID is a more important factor in the development of AF in mitral valvular heart disease than LAID considered in conjunction with BSA and that an absolute LAID of 50 mm may be used as a reliable guide to therapeutic and prophylactic intervention in AF associated with mitral valular heart disease.
Atrial Fibrillation* ; Heart Diseases ; Heart Valve Diseases ; Humans

Sertoli-Leydig cell tumors of the ovary are rare, accounting for no more than 0.5% of all ovarian neoplasms. These tumors occur predominantly in women 10 to 30 years of age. Heterologous elements are found in over 20% of the moderately and poorly differentiated Sertoli- Leydig cell tumors. The most common element is gastrointestinal mucin-secreting epithelium, found in approximately 20% of all cases. Approximately 4% of Sertoli-Leydig cell tumors contain immature skeletal muscle and/or cartilaginous elements. The origin of these neoplasms is regarded as neometaplasia of the mesodermal neoplastic element. While the degree of differentiation of Sertoli-Leydig cell tumors is probably of greater importance in determining prognosis than the presence of heterologous components, recent evidence does point to an unfavorable effect on clinical outcome when heterologous mesenchymal components such as cartilage and striated muscle are present. We experienced two cases of ovarian heterologous Sertoli-Leydig cell tumors with gastrointestinal type epithelium and striated skeletal muscle in 20 and 21 year-old females, respectively. One case involved a patient who had complained of amenorrhea for 3 years while the other case involved a patient who had complained of left lower abdominal tenderness and amenorrhea for one and one half years. It was determined by ultrasonography of the pelvis that the two patients suffered from right and left ovarian masses. Both patients underwent adnexectomy. These tumors were large with partly solid and partly cystic areas. Based on light microscopic examination one case was classified as an intermediate Sertoli-Leydig cell tumor with heterologous gastrointestinal type epithelium, while the other case was classified as a poorly differentiated Sertoli-Leydig cell tumor with heterologous striated skeletal muscle.
Female ; Humans

A case of primary gastric carcinoma with patterns resembling those of hepatocellular carcinoma(HCC) is reproted. This patient who represented high serum alpha-fetoprotein(AFP) underwent a subtotal gastrectomy for stomach cancer and lobectomy of liver metastasis. The hepatoid component of the tumor was characterized by solid nests of large polygonal cells arranged in cords and trabeculae, with central nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm; single-nuclear giant cells were frequently noted. These tumor cells of stomach stained positive immunohistochemically for AFP, ACT(alpha-1-antitrypsin), AACT(alpha-1-antichy-motrypsin). Thus, this hepatoid gastric adenocarcinoma tumor cells demonstrated both morphologic and immunohistochemical features of partial differentiation to the HCC. Careful histologic examination in conjunction with the immunohistochemical demonstration of AFP can provide a useful contribution to the diagnosis of this rare histological type of gastric carcinoma And the presence of metastatic hepatoid adenocarcinoma from the stomach should be considered in a patient with hepatic tumor mimicking HCC. Because of frequent venous and lymphatic invasion, as well as liver metastasis, prognosis appears to be poor. The authors reviewed 45 cases of hepatoid adenocarcinoma of stomach reported in the literature, also.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Neoplasm Metastasis ; Stomach Neoplasms

BACKGROUND: The two most commonly used drugs as a stressor during wtress echocardiography are dipyridamole and dobutamine. The purpose of this study was to compare diagnostic accuracies of dipyridamole and dobutamine stress echocardiography for fixed coronary artery disease and evaluate complications related to the two agents in the same patients. METHODS: 30(M : 5=19 : 11, age=56+/-8.8yr) consecutive patients without history of previous myocardial infarction underwent coronary angiography, dipyridamole and dobutamine stress echocardiography in random order. Dipyridamole was infused up to 0.84mg/Kg for 10 minutes during clinical, ECG and echocardiographic montioring. Dobutamine was infused in dose increments from 5 to 40microg/Kg/min under the same condition. Positive criteria for myocardial ischemia by echocardiography was now regional wall mation abnormatity or worsening of regional wall motion after stress. Significant coronary disease was defined as more than 70% stenosis by coronary angiography. RESULTS: The sensitivity and specificity of both stress echocardiography were same, 82% and 92% respectively. In a single vessel disease the sensitivity of dipyridamole echocardiography was 75% and dobutamine echocardiography was 83% without statistical difference. The correlation of ischemic free time during both stress test was 0.375. During dipyridamole infusion no test was prematurely terminated because of side effects, but 3 patients(10%) developed severe hypertension and ventricular arrytricular arrythmia during dobutamine infusion and test was terminated. CONCLUSION: Thus, by this prospective direct comparison of both stress test, dipyridamole and dobutamine stress echocardiography have similar diagnostic accuracies for the detection of coronary artery disease. But during dobutamine infusion, careful monitoring for hemodynamic changes arrythmia is required for possible serious complications.
Arrhythmias, Cardiac ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Dipyridamole* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Sensitivity and Specificity

The nevus of Ota is a benign dermal melanocytic lesion that most commonly occurs unilaterally in areas innervated by the first and second division of the trigeminal nerve. Acquired bilateral nevus of Ota-like macules(ABNOM) are located bilaterally on the forehead, temples, eyelids, cheeks, and/or nose. They usually occur in the fourth or fifth decade of life in women(rarely in men). In contrast to the nevus of Ota, ABNOM have not been observed in the mucous membranes of the oral cavity, nose, or eyes. Traditional treatments were palliative, risky electrocautery, or cryotherapy. These methods resulted in permanent pigmentary changes and/or scarring. Recently utilizing the principle of selective photothermolysis, the Q-switched Alexandrite laser has been reported to be successful in treating benign pigmentary lesions and tattoos. Our study evaluated the treatment of 127 patients with nevus of Ota and ABNOM with the Q-switched Alexandrite laser(755 nm, 100 nsec). Nevi were treated up to 7 times with 7-8 J/cm2 at a minimum of 6 weeks interval. Good therapeutic effects were gained (up to 50% improvement was seen in 89% of patients.) and our patients were very satisfied. No patients had permanent textural change or scarring. Treatment with on Alexandrite laser for nevus of Ota & ABNOM is considered to be a safe and effective method.
Cheek ; Cicatrix ; Cryotherapy ; Electrocoagulation ; Eyelids ; Forehead ; Humans ; Lasers, Solid-State* ; Mouth ; Mucous Membrane ; Nevus of Ota ; Nevus* ; Nose ; Trigeminal Nerve

In an attempt to investigate which of the ST-segment parameters, e.g., ST-segment level, ST-segment slope, ST-segment index and ST-segment intergral obtained by mannual drawing can most sensitively indicate quantitatively the extent of exertional myocardial ischemia in patients with angina pectoris, 26 patients with angina pectoris underwent exrecise stress testing, using a bicycle ergometer and thallium-201 myocardial perfusion scintigraphy(Thallium-201 MPS). The exrecise was terminated either when symptoms or signs indicative of myocardial ischemia developed or when the heart rate reached the predicted maximal heart rate during exrecise. The myocardial ischemia region was quantitated by Thallium-201 MPS. The number of myocardial ischemia segments was similar in patients who had positive exrecise test(4.9+/-1.9) and in those who had negative result(3.7+/-2.2). However, it was greater in patients who showed pseudonormalization of the T wave in exercise ECG(6.3+/-2.6) than in those with negative exercise test(3.7+/-2.2)(P<0.05). The extent of myocardial ischemia region expressed by the number of myocardial ischemia segments correlates best with the ST-segment index(r=-0.83) among ST-segment slop(r=-0.60), ST-segment intergral(r=-0.59) and ST-segment(r=0.50). These data suggest that the ST-segment index is the most reliable indicator to reveal the extent of exertional myocardial ischemia among the ST-segment parameters and that pseudonormalization of T wave in exercise ECG is a finding indicative of exertional myocaridial ischemia in patients with angina pectoris.
Angina Pectoris ; Electrocardiography* ; Exercise Test ; Heart Rate ; Humans ; Ischemia ; Myocardial Ischemia* ; Perfusion

OBJECTIVES: We surveyed this study for knowing the relation within stress, depression and medical comorbidities, and finding the risk factors of major depression. METHODS: 1764 subjects were enrolled from Jan. 2009 to Dec. 2009 who visit Korea University Guro hospital healthcare center. The subjects answered the questionnaire of PSS(Perceived Stress Scale), PHQ-9(Patient Health Questionnaire-9) and the demographic data. We categorized them as the stress group, depressive group, medical comorbidity group and analyzed the correlation analyses and logistic regression analyses. RESULTS: 198 of 1764 subjects(11.8%) were applied to major depression, and the depressive group showed the higher mean stress score(23.19) and mean depression score(12.95) than the normal group. The total PHQ-9 score was increased by perceiving more stress, having more medical comorbidities. The subjects with female, visiting due to recent health problems, irregular exercise, current smoking, history of angina and cerebrovascular disease showed the increased risk of major depression. CONCLUSIONS: In this study, we find the PSS, PHQ-9 were valuable for mental health screening in healthcare center. As perceiving more stress and having more medical comorbidity, risk of major depression were increased. Accordingly the individuals with medical diseases or unhealthy lifestyle would need the mental health screen.
Comorbidity ; Delivery of Health Care ; Depression ; Female ; Humans ; Korea ; Life Style ; Logistic Models ; Mass Screening ; Mental Health ; Questionnaires ; Risk Factors ; Smoke ; Smoking

No abstract available.
Noise* ; Organ of Corti*

A various type of hairline and height of forehead is considered as a result of genetic effect. The conventional corrective surgical operation of low hairline in forehead has been too complicated and painful to apply, and also has many disadvantages such as scar, bleeding, risks of anesthesia. Recently four classes of devices are designed to remove hair with intense light beam : Nd-Yag lasers with carbon cream, the Ruby lasers, the Alexandrite lasers, and the polychromic broad band light source of flashlamp technology. The goal of these therapeutic modality is to destroy the melanin pigment selectively in hair follicle without injuring the skin for permanent epilation. We have been used long pulse infrared Alexandrite laser for treat low hair line in 27 patients from Dec. 1997 to Dec. 1998. We experienced 3 cases of temporary hyperpigmentation and 1 case of bulla, and the most of patients were satisfied in 89%. The average lengthening of forehead was 2.2cm (median line) and 2.3cm (paramedian line). We achieved successful result without permanent hyperpigmentation or scarring
Anesthesia ; Carbon ; Cicatrix ; Forehead ; Hair Follicle ; Hair Removal ; Hair* ; Hemorrhage ; Humans ; Hyperpigmentation ; Lasers, Solid-State* ; Melanins ; Skin