BACKGROUND: Previously, cutaneous lymphomas were classified according to either the European Organization for the Research and Treatment of Cancer (EORTC) or the World Health Organization (WHO) classification paradigms. The aim of this study was to determine the relative frequency of Korean cutaneous lymphoma according to the new WHO-EORTC classification system. METHODS: A total of 517 patients were recruited during a recent 5 year-period (2006-2010) from 21 institutes and classified according to the WHO-EORTC criteria. RESULTS: The patients included 298 males and 219 females, and the mean age at diagnosis was 49 years. The lesions preferentially affected the trunk area (40.2%). The most frequent subtypes in order of decreasing prevalence were mycosis fungoides (22.2%), peripheral T-cell lymphoma (17.2%), CD30+ T-cell lymphoproliferative disorder (13.7%), and extranodal natural killer/T (NK/T) cell lymphoma, nasal type (12.0%). Diffuse large B-cell lymphoma accounted for 11.2% of cases, half of which were secondary cutaneous involvement; other types of B-cell lymphoma accounted for less than 1% of cases. CONCLUSIONS: In comparison with data from Western countries, this study revealed relatively lower rates of mycosis fungoides and B-cell lymphoma in Korean patients, as well as higher rates of subcutaneous panniculitis-like T-cell lymphoma and NK/T cell lymphoma.
Academies and Institutes ; Classification* ; Diagnosis ; Female ; Humans ; Korea ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Lymphoproliferative Disorders ; Male ; Mycosis Fungoides ; Prevalence ; T-Lymphocytes ; World Health Organization

BACKGROUND: The aim of study was to determine the relative frequency of malignant lymphoma according to World Health Organization (WHO) classification in Korea. METHODS: A total of 3,998 cases diagnosed at 31 institutes between 2005 and 2006 were enrolled. Information including age, gender, pathologic diagnosis, site of involvement and immunophenotypes were obtained. RESULTS: The relative frequency of non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) was 95.4% and 4.6%, respectively. B-cell lymphomas accounted for 77.6% of all NHL, while T/natural killer (T/NK)-cell lymphomas accounted for 22.4%. The most frequent subtypes of NHL were diffuse large B-cell lymphoma (42.7%), extranodal marginal zone B-cell lymphoma (MZBCL) of mucosa-associated lymphoid tissue (19.0%), NK/T-cell lymphoma (6.3%) and peripheral T-cell lymphoma (PTCL), unspecified (6.3%), in decreasing order. The relative frequency of HL was nodular sclerosis (47.4%), mixed cellularity (30.6%), and nodular lymphocyte predominant (12.1%) subtypes. Compared with a previous study in 1998, increase in gastric MZBCL and nodular sclerosis HL, and slight decrease of follicular lymphoma, PTCL, and NK/T-cell lymphoma were observed. CONCLUSIONS: Korea had lower rates of HL and follicular lymphoma, and higher rates of extranodal NHL, extranodal MZBCL, and NK/T-cell lymphoma of nasal type compared with Western countries. Changes in the relative frequency of lymphoma subtypes are likely ascribed to refined diagnostic criteria and a change in national health care policy.
Academies and Institutes ; Delivery of Health Care ; Hodgkin Disease ; Korea ; Lymphocytes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Follicular ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell, Peripheral ; Sclerosis ; World Health Organization

BACKGROUND: CD44 protein is known as a homing cellular adhesion molecule that is linked to diverse cellular functions such as adhesion, migration and invasion, which are all important in cancer progression and metastasis. The expression of CD44 standard and variant isoforms (CD44 standard isoform [CD44s] and CD44 splice variants containing exon v6 [CD44v6], respectively) is associated with an unfavorable clinical outcome in various neoplasms. METHODS: Forty patients who were diagnosed with diffuse large B-cell lymphoma (DLBCL) through biopsy at Hanyang University Hospital between 1996 and 2003 were included in this study. CD44 proteins expression was analyzed by immunohistochemical staining on a tissue microarray and the correlation of CD44 with the types of DLBCL and clinical parameters, including the factors defined by the International Prognostic Index, was evaluated. RESULTS: A high CD44s and intermediate to strong CD44v6 expression, including cytoplasmic membranous staining patterns, was present in 35% (14/40) and 25% (10/40) of DLBCL patients, respectively. High CD44s expression was correlated significantly with non-germinal center B-cell-like types (non-GCB, p=0.004) and patients with old age (p=0.041). CONCLUSIONS: High CD44s expression may be significantly associated with the non-GCB type compared to the GCB type and may be essential to the prediction of disease outcome in tumor stage III in DLBCL patients.
Antigens, CD44 ; B-Lymphocytes ; Biopsy ; Cytoplasm ; Exons ; Humans ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; Neoplasm Metastasis ; Protein Isoforms ; Proteins

BACKGROUND: Programmed death-1 (PD-1) is physiologically expressed by germinal center-associated helper T-cells and has an inhibitory effect on T-cell activity. METHODS: We examined 63 cases of diffuse large B-cell lymphoma (DLBCL) and determined the number of PD-1-positive helper T-cells in a representative tumor area after immunohistochemical staining using a monoclonal antibody against PD-1. The PD-1-positive cells were counted in 3 high-power fields (HPFs; 400x). RESULTS: Patients were divided into 2 groups: one with a high number of PD-1-positive cells (>20/HPF, n=33) and one with a low number of PD-1-positive cells (< or =20/HPF, n=30). The former group showed decreased overall survival, but at a statistically non-significant level (p=0.073). A high number of PD-1-positive cells was more common in patients at an advanced clinical stage and with high international prognostic index score (p=0.025 and p=0.026, respectively). The number of extranodal sites also somewhat correlated with the PD-1 staining status (p=0.071). However, the number of PD-1-positive cells was not associated with patient age, serum lactate dehydrogenase level, and Eastern Cooperative Oncology Group performance score. CONCLUSIONS: The high number of PD-1-positive cells might be associated with an unfavorable outcome in DLBCL patients.
B-Lymphocytes ; Humans ; L-Lactate Dehydrogenase ; Lymphocytes, Tumor-Infiltrating ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large B-Cell, Diffuse ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer

BACKGROUND: Subarachnoid block is widely used for cesarean section due to the rapid induction, the complete analgesia, the low failure rate and the prevention of aspiration pneumonia. The addition of intrathecal opioids to local anesthetics seems to improve the quality of analgesia & prolong the duration of analgesia. Therefore we compared the effects of fentanyl 20 microg and sufentanil 2.5 microg, which were added to intrathecal hyperbaric bupivacaine. METHODS: Seventy two healthy term parturients were randomly divided into three groups: Group C (control), Group F (fentanyl 20 microg) and Group S (sufentanil 2.5 microg). In every group, 0.5% heavy bupivacaine was added according to the adjusted dose regimen by Harten et al. We observed the maximal level of the sensory block and motor block, the quality of intraoperative analgesia, the duration of effective analgesia and the side effects. RESULTS: There were significant differences between the control and the fentanyl 20 microg and sufentanil 2.5 microg groups for the degree of muscle relaxation, the quality of intraoperative analgesia, the maximal sedation level and the duration of effective analgesia. The frequencies of side effects such as nausea and pruritis in the opioid groups were higher than those in the control group. But there were no differences between fentanyl 20 microg and sufentanil 2.5 microg for the frequencies of nausea and pruritis. CONCLUSIONS: The addition of fentanyl 20 microg or sufentanil 2.5 microg for spinal anesthesia provides adequate intraoperative analgesia without significant adverse effects on the mother and neonate.
Analgesia ; Analgesics, Opioid ; Anesthesia, Spinal ; Anesthetics, Local ; Bupivacaine ; Cesarean Section ; Female ; Fentanyl ; Humans ; Infant, Newborn ; Mothers ; Muscle Relaxation ; Nausea ; Pneumonia, Aspiration ; Pregnancy ; Pruritus ; Sufentanil

Patients with pheochromocytoma manifest with headache, perspiration, and palpitation. Although most patients have either sustained or paroxysmal hypertension, some patients present with hypotension. However, severe orthostatic hypotension is relatively rare in patients with pheochromocytoma. We report here on a 72-year-old woman with pheochromocytoma and she presented with recurrent syncope due to hypotension and blood pressure fluctuation. Syncope due to hypotension is unusual in patients with pheochromocytoma and only a few such cases have been reported. The present case serves to illustrate an unexpected presentation of this tumor.
Aged ; Blood Pressure ; Female ; Headache ; Humans ; Hypertension ; Hypotension ; Hypotension, Orthostatic ; Pheochromocytoma ; Syncope

BACKGROUND: The Hematopathology Study Group of the Korean Society of Pathologists conducted a nation-wide retrospective analysis of Korean pediatric lymphoma, to provide pathologic data on pediatric/adolescent lymphoma subtypes and features. METHODS: All lymphoma cases of all age groups were collected during a recent 2 year-period (2005-2006) from 32 institutes in Korea. Among 3,686 lymphoma patients, 142 who were age 18 or less were classified according to the World Health Organization (WHO) classification. RESULTS: Among 142 pediatric/adolescent lymphoma patients, Hodgkin lymphoma accounted for 21 (14.8%) and non-Hodgkin lymphoma (NHL) for 121 (85.2%). Hodgkin lymphoma appears to be more common in the pediatric/adolescent age group than in the all-ages group (14.8% vs 4.4%). T- and natural killer cell-NHL was more common in the pediatric/adolescent age group than in the all ages group (46.3% vs 22%). The majority of Korean pediatric/adolescent NHL cases was composed of Burkitt lymphoma, T- or B-lymphoblastic lymphoma, anaplastic large-cell lymphoma, and diffuse large B-cell lymphoma. For lymphoma patients under the age of 6 years, most had B-lymphoblastic or Burkitt lymphoma, which commonly presented at extranodal sites. CONCLUSIONS: The distribution of lymphoma subtypes in the pediatric/adolescent age group is quite different from the distribution of adults, but it was quite similar to distribution in Western countries.
Academies and Institutes ; Adult ; Burkitt Lymphoma ; Hodgkin Disease ; Humans ; Incidence ; Korea ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin ; Retrospective Studies ; World Health Organization

PURPOSE: It is controversial to treat complicated appendicitis in pediatric patients on several points, especially optimal time for appendectomy. The purpose of this study is to determine optimal time for operation in perforated appendicitis in pediatric patients. METHODS: Children with perforated appendicitis under the age of 14 underwent appendectomy between January 2006 and December 2008 at Ewha Womans University Mokdong Hospital were analyzed retrospectively according to factors which may affect the postoperative hospital course such as complications, time of beginning of diet, and length of hospital stay. RESULTS: During the study period, 357 patients with acute appendicitis underwent appendectomy and 118 patients were diagnosed with perforated appendicitis. Comparing symptom durations between more than 48 hours and less, the former induced significantly higher postoperative complication rates. Body temperature above 37.5degrees C at admission affected significantly higher complication rates and delay of beginning of diet. Children with intraabdominal abscess at appendectomy showed higher complication rates than without abscess. Children who underwent operation in the daytime started diet significantly earlier and showed less complication than those operated on at night. The frequency of preoperative antibiotics administration did not alter the postoperative hospital course. CONCLUSION: For the children diagnosed with perforated appendicitis, non-urgent appendectomy in the daytime after initial conservative management including intravenous administration of antibiotics, hydration, and correction of serum electrolyte is safer and more efficient than performing emergency operation, and moreover there is no necessity for secondary admission for interval appendectomy.
Abscess ; Administration, Intravenous ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Body Temperature ; Child ; Diet ; Emergencies ; Female ; Humans ; Postoperative Complications ; Retrospective Studies

A thermal neutron beam facility utilizing a typical tangential beam port for Neutron Capture Therapy was installed at the HANARO, 30 MW multi-purpose research reactor. Mixed beams with different physical characteristics and relative biological effectiveness would be emitted from the BNCT irradiation facility, so a quantitative analysis of each component of the mixed beams should be performed to determine the accurate delivered dose. Thus, various techniques were applied including the use of activation foils, TLDs and ionization chambers. All the dose measurements were performed with the water phantom filled with distilled water. The results of the measurement were compared with MCNP4B calculation. The thermal neutron fluxes were 1.02E9 n/cm2 s and 6.07E8 n/cm2 s at 10 and 20 mm depth respectively, and the fast neutron dose rate was insignificant as 0.11 Gy/hr at 10 mm depth in water. The gamma-ray dose rate was 5.10 Gy/hr at 20 mm depth in water. Good agreement within 5%, has been obtained between the measured dose and the calculated dose using MCNP for neutron and gamma component and discrepancy with 14% for fast neutron flux. Considering the difficulty of neutron detection, the current study support the reliability of these results and confirmed the suitability of the thermal neutron beam as a dosimetric data for BNCT clinical trials.
Fast Neutrons ; Neutron Capture Therapy* ; Neutrons* ; Relative Biological Effectiveness ; Water

PURPOSE: To raise awareness of the clinical importance of, and the need for proper management of acute focal bacterial nephritis(AFBN), we analyzed 22 AFBN patients and 22 other upper urinary tract infection patients by use of comparative studies. METHODS: From January 2000 to May 2002, 22 AFBN patients aged from 1 month to 12 months were selected. As a control group, 22 UTI patients with no radiologic abnormalities were selected and matched by age and sex. RESULTS: The incidence of AFBN was more common in boys than in girls. Since both groups had similar symptoms, it was difficult to diagnose AFBN by clinical presentations alone. ESR and CRP were significantly higher in AFBN patients. The most common causative organism was E. coli in both groups. On the sonographic findings, the most lesions were seen on the upper lobe of the kidney; more frequently, on left kidney. The lesions showed globular or wedge-shaped increased echogenecity. 99mTc-DMSA scan showed the complete coincidence of the location, size and shape in all cases compared to the findings of renal sonography. CONCLUSION: The roles of renal sonography and DMSA scan were very important, and ultrasonography was an excellent initial tool in diagnosing AFBN. Since the degree of infection in AFBN is more severe than other urinary tract infections and evollution into a renal abscess is possible, early diagnosis and appropriate antibiotics therapy is essential.
Abscess ; Anti-Bacterial Agents ; Child* ; Early Diagnosis ; Female ; Humans ; Incidence ; Kidney ; Nephritis* ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid ; Ultrasonography ; Urinary Tract Infections