The diagnosis of primary cutaneous lymphoma is based on a combination of clinical, histological, immunophenotypic and genetic criteria. Nineteen cases of primary cutaneous lymphomas were studied for clinicopathologic, immunophenotypic, and genetic features. Seventeen (89%) cases were T cell origin and two cases (11%) were B cell origin. CD30-positive cutaneous lymphoproliferative disorder was the most frequent subtype, occupying 42% (8 cases) of the cases. CD8 was positive in 5 cases consisting of 3 cutaneous T cell lymphomas and 2 anaplastic large cell lymphomas. CD4 was positive in 2 cases of mycosis fungoides and 3 cases of lymphomatoid papulosis. Six (67%) of 9 cases of cutaneous T cell lymphoma were positive for TIA-1. Ten (83%) out of 12 cases showed clonal rearrangements of TCR gamma genes, however, one T/NK cell lymphoma and one anaplastic large cell lymphoma did not. EBV association was detected only in T/NK cell lymphomas among 10 cases examined. In conclusion, our study showed higher proportion of CD30-positive lymphoproliferative disorders and less frequent mycosis fungoides in Korea compared to the incidences in Western countries. Our immunostaining results suggested that mycosis fungoides and lymphomatoid papulosis are CD4-positive T cell origin, however, the remaining primary cutaneous T cell lymphoma is predominantly CD8-positive cytotoxic T cell origin.
Diagnosis ; Genes, T-Cell Receptor gamma ; Herpesvirus 4, Human ; Incidence ; Korea ; Lymphoma* ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell, Cutaneous ; Lymphomatoid Papulosis ; Lymphoproliferative Disorders ; Mycosis Fungoides

Kyphotic deformity arising from the failure in formation of a vertebral body is an uncommon condition showing late complications of gross spinal angulation, paraplegia, impaired bladder function and cardiopulmonary deficiencies. Congenital hemivertebra constitute approximately 6% of anomalies associated with congenital spinal deformities. The natural course of this disease remains unpredictable, especially regarding the development of neurological impairment. Only a few numbers of patients with severe kyphosis due to congenital dorsal hemivertebra have been reported. We present a 40-year-old man with severe thoracic kyphosis. Gait difficulty due to paraplegia occurred at the age of fifteen with progressive development of the right lower limb pain and later impairment of bladder function. He had no cardiopulmonary deficiencies. Radiological findings showed a wedge shaped dorsal hemivertebra and cord compression at the eleventh level of thoracic vertebra. In view of the poor prognosis of surgical intervention he was fitted with an Jewett brace so that further neurological impairment was avoided. We report a rare case of congenital kyphosis due to dorsal hemivertebra in adult with progressive neurological impairment.
Adult* ; Braces ; Congenital Abnormalities ; Gait ; Humans ; Kyphosis* ; Lower Extremity ; Paraplegia ; Prognosis ; Spine ; Urinary Bladder

BACKGROUND: With increase of antibiotics use and invasive procedures, infections caused by multi-resistant Acinetobacter baumannii (MRAB) are increasing. Recently, we experienced the outbreak of- nosocomial infections caused by MRAB resistant to imipenem and cefoperazone/sulbactam in intensive care units (ICU) and general ward. We analyzed the clinical characteristics of the infected patients and antibiotic susceptibility of the organisms. And surveillance cultures and IRS-PCR were performed to find out the transmission route. METHODS: We collected data from physical examination and clinical records. We performed surveillance cultures of environment, patients not infected with MRAB in ICU, and hands of health care workers. RESULTS: Between November 1996 and June 1997, 49 strains of MRAB were isolated from the 26 patients hospitalized in Kangnam St. Mary' s Hospital. The lower respiratory infection (13 cases) was the most common infection and sputum was the most common sources (47.1%). All strains of MRAB showed the same genotype. In disk diffusion test, all strains were resistant to piperacillin, gentamicin, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, imipencm, ciprofloxacin. From the surveillance cultures, the genotypically identical strains were isolated from ventilator Y-piece, the floor of ICU, and hands of health care workers. It suggested that this strain was transmitted through ventilatory device or hands of health care workers. We instructed all the health care workers to wash hands, to disinfect hospital environment completely. Since July 1997, no further case has occurred. CONCLUSIONS: Since A. baumannii could be transmitted through ventilatory devices and the hands of health care workers, it is important to wash hands and to disinfect hospital environment completely.
Acinetobacter baumannii* ; Acinetobacter* ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Ceftazidime ; Ciprofloxacin ; Cross Infection* ; Delivery of Health Care ; Diffusion ; Genotype ; Gentamicins ; Hand ; Humans ; Imipenem* ; Critical Care Units ; Patients' Rooms ; Physical Examination ; Piperacillin ; Sputum ; Ventilators, Mechanical

Intraductal papillary mucinous neoplasm (IPMN) is a recently recognized clinicopathologic entity characterized by dilatation of pancreatic duct filled with copious mucin and papillary ductal epithelial proliferation ranging from simple hyperplasia to invasive carcinoma. The exact clinicopathologic identification of this tumor is important because of favorable prognosis contrast to that of conventional ductal adenocarcinoma. Herein we report a case of surgically resected typical IPMN. A 59-year-old man had a long history of diabetes mellitus with epigastric pain of 4 months duration. Ultrasonography and computed tomographic examination revealed cystic dilatations of main pancreatic duct in the head. The patient underwent total pancreatectomy. The gross appearance showed diffuse dilatation of main pancreatic duct associated with cystic dilatation of subbranches in the uncinate process. Histologic examination revealed diffuse papillary proliferations lined by mucinous epithelium with mild atypism within ectatic ducts. No invasive carcinoma was noted. Histochemically, the papillary epithelium contained mostly neutral and acid sialomucin.
Male ; Humans

No abstract available.
alpha-Fetoproteins* ; Chorion* ; Chorionic Gonadotropin* ; Female ; Humans ; Pregnancy ; Pregnancy Trimester, First*

BACKGROUND: Pulmonary tuberculosis is affected by environmental factors, such as hygiene, nutrition, and socioeconomic status. Recently it has also been shown to be correlated with specific HLA types in foreign countries, although the mechanism underlying this association remains unknown. The aim of this study was to investigate the frequency and contribution of specific HLA alleles to pulmonary tuberculosis in Koreans. METHODS: HLA alleles of 97 patients whose illness was diagnosed as pulmonary tuberculosis by sputum acid-fast bacilli stain, culture, chest X-ray, and clinical evaluation at the Korean National Tuberculosis Association Department of Medical Operation were compared to those of 100 blood donors as controls. The polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method was used to define HLA-DQA1, HLA-DQB1, and HLA-DRB1 alleles. RESULTS: Among the patients analyzed by PCR- SSOP for HLA-DQA1 alleles, 63.9% were typed as HLA-DQA1*01, 50.5% HLA-DQA1*03, 22.6% HLA- DQA1*05, 8.2% HLA-DQA1*02, 7.2% HLA-DQA1* 06, and 4.1% HLA-DQA1*04. No difference in the distribution of HLA-DQA1 alleles between patients and healthy controls could be found, with the exception of HLA-DQA1*04, which was more common among controls. Regarding HLA-DQB1 alleles among the patients, 60% were typed as HLA-DQB1*03, 45% HLA-DQB1*06, 21.3% HLA-DQB1*04, 18.8% HLA- DQB1*05, and 11.3% HLA-DQB1*02. The allele distribution of HLA-DQB1 was not significantly different between patients and controls. For HLA-DRB1 alleles, 29.5% were typed as HLA-DRB1*02, 27.4% HLA- DRB1*08, 25.3% HLA-DRB1*04, 23.2% HLA-DRB1* 09, 20% HLA-DRB1*12, and 12.6% HLA-DRB1*13. There was also no difference between patients and controls in the allele distribution of HLA-DRB1. CONCLUSION: In Korea, where tuberculosis is relatively prevalent, pulmonary tuberculosis seems to be independent of HLA-DQA1, HLA-DQB1, and HLA- DRB1, although we found a statistically significant difference in HLA-DQA1*04 frequency between tuberculosis patients and controls.
Alleles ; Blood Donors ; HLA-DRB1 Chains* ; Humans ; Hygiene ; Korea ; Oligonucleotide Probes* ; Social Class ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: Pulmonary tuberculosis is affected by environmental factors, such as hygiene, nutrition, and socioeconomic status. Recently it has also been shown to be correlated with specific HLA types in foreign countries, although the mechanism underlying this association remains unknown. The aim of this study was to investigate the frequency and contribution of specific HLA alleles to pulmonary tuberculosis in Koreans. METHODS: HLA alleles of 97 patients whose illness was diagnosed as pulmonary tuberculosis by sputum acid-fast bacilli stain, culture, chest X-ray, and clinical evaluation at the Korean National Tuberculosis Association Department of Medical Operation were compared to those of 100 blood donors as controls. The polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method was used to define HLA-DQA1, HLA-DQB1, and HLA-DRB1 alleles. RESULTS: Among the patients analyzed by PCR- SSOP for HLA-DQA1 alleles, 63.9% were typed as HLA-DQA1*01, 50.5% HLA-DQA1*03, 22.6% HLA- DQA1*05, 8.2% HLA-DQA1*02, 7.2% HLA-DQA1* 06, and 4.1% HLA-DQA1*04. No difference in the distribution of HLA-DQA1 alleles between patients and healthy controls could be found, with the exception of HLA-DQA1*04, which was more common among controls. Regarding HLA-DQB1 alleles among the patients, 60% were typed as HLA-DQB1*03, 45% HLA-DQB1*06, 21.3% HLA-DQB1*04, 18.8% HLA- DQB1*05, and 11.3% HLA-DQB1*02. The allele distribution of HLA-DQB1 was not significantly different between patients and controls. For HLA-DRB1 alleles, 29.5% were typed as HLA-DRB1*02, 27.4% HLA- DRB1*08, 25.3% HLA-DRB1*04, 23.2% HLA-DRB1* 09, 20% HLA-DRB1*12, and 12.6% HLA-DRB1*13. There was also no difference between patients and controls in the allele distribution of HLA-DRB1. CONCLUSION: In Korea, where tuberculosis is relatively prevalent, pulmonary tuberculosis seems to be independent of HLA-DQA1, HLA-DQB1, and HLA- DRB1, although we found a statistically significant difference in HLA-DQA1*04 frequency between tuberculosis patients and controls.
Alleles ; Blood Donors ; HLA-DRB1 Chains* ; Humans ; Hygiene ; Korea ; Oligonucleotide Probes* ; Social Class ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube. CONCLUSION: These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.
Catheters ; Compliance ; Diabetes Mellitus ; Glasgow Coma Scale ; Hand Disinfection* ; Hand* ; Humans ; Incidence* ; Intensive Care Units* ; Critical Care* ; Intubation ; Length of Stay ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia* ; Risk Factors ; Suction* ; Tracheostomy ; Ventilators, Mechanical

The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

No abstract available.
Humans ; Outpatients*