BACKGROUND: Peripheral T cell lymphoma (PTCL), a prevalent form of non Hodgkin lymphomas in East Asia, can manifest fever, hepatomegaly, lymphadenopathy, pancytopenia and hemophagocytic histiocytosis (HPH). Similar clinicopathologic findings are also frequently encountered in reactive hemophagocytic syndrome (HPS) and malignant histiocytosis (MH) , thus diagnoses could be confused among them. With recent advancement of immunohistochemlal techniques, diagnostic accuracies have been improved and most cases of MH could have been reclassified as PTCL. In this study, we intended to delineate the lineage of atypical malignant cells in bone marrow of subjects which were previously diagnosed as MH or HPS with immunohlstochemical analysis and characterize clinlcophathologic findings of PTCL associated with HPH in the bone marrow. METHODS: Five cases dignosed as HPS, 3 as MH, 3 as presumed MH, and 7 as PTCL on bone marrow examination were enrolled in this study. We performed immunohistochemical stain for CD45, CD3, CD43, CD2O and CD68, then revised the diagnoses and summarized the clinical and morphologic features of PTCL associated with HPH. RESULTS: Eleven out of 18 cases were confirmed as PTCL which were previously diagnosed as MH(1), presumed MH(3) and PTCL(7). Eight cases of 11 PTCL showed HPH mimicking MH with infiltration of the atypical malignant cells, even if the proportion of atypical malignant cells was small on bone marrow aspirates. They manifested fever and hepatomegaly but didn't have lymphadenopathy at the early stage of disease. Subtypes of PTCL with HPH were PTCL, unspecifed (3), angioimmunoblastic T cell lymphoma (1) and undetermined (4). They showed poorer outcome in 3-month survival rate (25%) than in those with PTCL without HPH(100%). CONCLUSION: These results suggest that PTCL associated with HPH should be excluded from MH by immunohistochemical analysis. Considering that prognosis of PTCL with HPH is very poor, accurate and rapid diagnosis is needed for prompt treatment.
Bone Marrow ; Bone Marrow Examination ; Diagnosis ; Far East ; Fever ; Hepatomegaly ; Histiocytic Sarcoma* ; Histiocytosis* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Pancytopenia ; Prognosis ; Survival Rate

PURPOSE: In vitro sonography of lymph nodes was performed to ascertain the differential point between benignancy and malignancy. MATERIALS AND METHODS: Ninty-one lymph nodes were obtained at gastric cancer surgery and pathologically proved as benignancy in 68 and malignancy in 23 cases. Sohographic and pathologic correlation of resected ninty one lymph nodes was done in terms of size, the ratio of longest diameter versus shortest diameter, central hyperechogenicity, and peripheral cortical echo. RESULTS: Sonographic findings of benign lymph node were small size, oval shape(85%), narrow central high echogenicity(44%), and symmetric cortical thickening(41%). Sonographic findings of malignant lymph node were large size, round contour(39%), loss of central high echogenicity(82%), and diffuse increase of cortical thickness(82%). CONCLUSION: The most reliable sonographic criterion for differentiation of benignancy from malignancy was size of a lymphnode.
Lymph Nodes* ; Stomach Neoplasms ; Ultrasonography

No abstract available.
Carpal Tunnel Syndrome*

PURPOSE: This study evaluated the prognostic differences in invasive cancer that progressed from a superficial transitional cell carcinoma (TCC) compared to an already invasive TCC at the time of the initial presentation. MATERIALS AND METHODS: Seventy-one patients who had a radical cystectomy performed for an invasive TCC were enrolled in this study. They were divided into two groups. In the first group, the patients were diagnosed as a superficial TCC at initially, which progressed to an invasive tumor. The second group consisted of patients who were diagnosed with invasive TCC at the time of the initial diagnosis. Two groups were compared with regard to the TNM stage, Ash grade, presence of accompanying carcinoma in-situ and survival rate. RESULTS: The group with invasive cancer at the time of the initial presentation had a significantly higher grade than the progressed group. The five-year survival rate was lower in the progressed group. Moreover, Kaplan-Meier analysis showed it was statistically significant (p=0.04). CONCLUSIONS: The grade was higher and the five-year survival rate was lower in the group with invasive cancer at the time of the initial presentation. Therefore, the invasive TCC at the initial diagnosis might take a more aggressive nature than the progressed group.
Carcinoma, Transitional Cell ; Cystectomy ; Diagnosis* ; Humans ; Kaplan-Meier Estimate ; Prognosis ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

No abstract available.
Adenoma*

BACKGROUND: Alterations in ventricular loading conditions lead to changes in action potential duration via mechanoelectrical feedback. A decrease in load immediately leads to prolongation of repolarization. QT interval and QT dispersion were measured to determine the long-term effect of changes in ventricular systolic load on the ventricular repolarization. METHOD: Corrected QT interval and QT dispersion were measured in 26 patients before and 3-6 months after valvuloplasty for pulmonary stenosis. To determine the effect of ventricular load on ventricular repolarization, patients were divided in 2 groups; Group 1 was those patients with a greater than 30 mmHg and Group 2 was those patients with a less than 30 mmHg decrease in right ventricular systolic pressure. RESULTS: Corrected QT interval (412.6+/-14.5 msec vs 426.4+/-16.8 msec, p < 0.05) and QT dispersion (35.0+/-7.3 msec vs 45.7+/-14..1 msec, p < 0.05)were increased significantly only in Group 1 after vlavuloplasty. CONCLUSION: It suggested that mechanoelectrical interactions are operative for long duration in humans that changes in ventricular load after successful pulmonary valvuloplasty showed long-term effect on the ventricular repolarization.
Action Potentials ; Balloon Valvuloplasty* ; Blood Pressure ; Humans ; Pulmonary Valve Stenosis*

PURPOSE: The purpose of this study was to investigate the final outcomes of magnetic resonance imaging (MRI)-identified additional lesions (MRALs) in breast cancer patients and the role of second-look ultrasound (SLUS) and imaging-guided interventions. METHODS: We analyzed breast cancer patients with MRALs on preoperative MRI between January and June 2012. MRALs were defined as additional lesions suspected on MRI but not suspected on mammograms or ultrasound. The malignancy rate of MRALs, MRI-based Breast Imaging Reporting and Database System (BI-RADS) category, positional relationship with the index cancer, MRI-concordant lesion visibility on SLUS, performance of imaging-guided interventions, and total mastectomy (TM) rates were evaluated for the confirmed lesions. RESULTS: Among the 119 confirmed lesions, SLUS and imaging-guided interventions were performed in 94 (79.0%) and 82 cases (68.9%), respectively. The malignancy rate was 68.1% (81 of 119), and was significantly higher in BI-RADS 4C-5 lesions than in 4A-4B lesions (94.6% vs. 56.1%, P < 0.01) and in ipsilateral same-quadrant lesions than in contralateral lesions (84.2% vs. 33.3%, P < 0.01). The lesion visibility rate on SLUS was 90.4%. The malignancy rate was not significantly different according to lesion visibility on SLUS. The TM rate in the 98 cases with ipsilateral MRALs was 37.8%, while it was significantly lower in patients who underwent an imaging-guided intervention than in those who did not (27.9% vs. 54.1%, P=0.017). CONCLUSION: MRALs show a high probability of malignancy, especially if they are ipsilateral. SLUS and imaging-guided interventions can eliminate many unnecessary TMs.
Breast Neoplasms* ; Breast* ; Humans ; Magnetic Resonance Imaging* ; Mastectomy, Simple ; Ultrasonography*

CT has an important role in the evaluation of gastric adenocarcinoma. It clearly demonstrates the primary tumor itself and reveals the spread of cancer to adjacent or distant structures. It is therefore useful in the staging of gastric carcinoma, and has proved valuable in the differential diagnosis of this and other gastrictumors. Recent advances in technology such as spiral CT with water ingestion, improve the value of CT. This report describes the characteristic findings of gastric adenocarcinomas by spiral CT, and elucidates its role in the staging of gastric carcinoma.
Adenocarcinoma* ; Diagnosis, Differential ; Eating ; Tomography, Spiral Computed* ; Water

No abstract available.
Delivery of Health Care* ; Family Practice* ; Humans ; Inpatients* ; Insurance* ; Korea*

Two patients with clinical and biochemical evidences of islet cell hyperfunction underwent percutaneous transhepatic portal and pancreatic vein catheterization and hormone assays. Local step-ups of insulin level in the protal venous system, found in two patients with insulinoma, corresponded to tumor sites at surgery. One patients had single insulinoma and the other had malignant insulinoma and liver metastasis. Percutaneous transhepatic protal and pancreatic vein catheterization with measurement of radioimmunoactive insulin concentration is a safe and reliable method, and may play an important role in the localization of adenoma in patients with hyperinsulinism.
Adenoma ; Adenoma, Islet Cell* ; Catheterization ; Catheters ; Diagnosis* ; Humans ; Hyperinsulinism ; Insulin ; Insulinoma ; Islets of Langerhans* ; Liver ; Methods ; Neoplasm Metastasis ; Veins