BACKGROUND: Pityriasis lichenoides (PL)-like skin lesions rarely appear as a specific manifestation of mycosis fungoides (MF). OBJECTIVE: We investigated the clinicopathological features, immunophenotypes, and treatments of PL-like MF. METHODS: This study included 15 patients with PL-like lesions selected from a population of 316 patients diagnosed with MF at one institution. RESULTS: The patients were between 4 and 59 years of age. Four patients were older than 20 years of age. All of the patients had early-stage MF. In all patients, the atypical lymphocytic infiltrate had a perivascular distribution with epidermotropism. The CD4/CD8 ratio was <1 in 12 patients. Thirteen patients were treated with either narrowband ultraviolet B (NBUVB) or psoralen+ultraviolet A (PUVA), and all of them had complete responses. CONCLUSION: PL-like MF appears to have a favorable prognosis and occurrence of this variant in adults is uncommon. MF should be suspected in the case of a PL-like skin eruption. Therefore, biopsy is required to confirm the diagnosis of PL-like MF, and NBUVB is a clinically effective treatment.
Adult ; Biopsy ; Diagnosis ; Humans ; Mycosis Fungoides* ; Phototherapy* ; Pityriasis Lichenoides ; Pityriasis* ; Prognosis ; Skin

Chimerism in humans is a rare phenomenon often initially identified in the resolution of an ABO blood type discrepancy. We report a dispermic chimera who presented with mixed field in his B antigen typing that might have been mistaken for the B3 subtype. The propositus is a healthy Korean male blood donor. Neither his clinical history nor initial molecular investigation of his ABO gene explained his mixed field agglutination with murine anti-B. Chimerism was suspected, and 9 short tandem repeat (STR) loci were analyzed on DNA extracted from blood, buccal swabs, and hair from this donor and on DNA isolated from peripheral blood lymphocytes from his parents. The propositus' red blood cells demonstrated mixed field agglutination with anti-B. Exon 6 and 7 and flanking intronic regions of his ABO gene were sequenced and revealed an O01/O02 genotype. B allele haplotype-specific PCR, along with exon 6 and 7 cloning and sequencing demonstrated a third ABO allele, B101. Four STR loci demonstrated a pattern consistent with a double paternal chromosome contribution in the propositus, thus confirming chimerism. His karyotype revealed a mosaic pattern: 32/50 metaphases were 46,XY and 18/50 metaphases demonstrated 47,XYY.
ABO Blood-Group System ; Adult ; Alleles ; Blood Grouping and Crossmatching ; Chimera ; Chimerism ; Chromosome Disorders/*diagnosis/*genetics ; Genotype ; Humans ; Karyotyping ; Korea ; Male ; Phenotype ; Sequence Analysis, DNA ; *XYY Karyotype

Microscopic polyangiitis is a systemic small-vessel vasculitis primarily associated with necrotizing glomerulonephritis and pulmonary capillaritis. This disease is determined by clinical manifestation, ANCA, and involved organ or renal biopsy. We describe a 49-year-old female presenting with chronic postnasal drip, progressive dyspnea and abrupt hemoptysis. Her serum p-ANCA was postitive, but c- ANCA was negative. Her chest X-ray and chest CT scan showed pulmonary hemorrhage, and the renal biopsy specimen revealed crescentic glomerulonephritis. She was diagnosed as having an ANCA-associated vasculitis, and more specifically, a microscopic polyangiitis accompanied with paranasal sinusitis. She was treated with intravenous methylprednisolone pulse therapy, followed by prednisolone and cyclophosphamide per oral tablets. She showed rapid progression of renal failure and died from sepsis after 2 months of treatment.
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Cyclophosphamide ; Dyspnea ; Female ; Glomerulonephritis ; Hemoptysis ; Hemorrhage* ; Humans ; Methylprednisolone ; Microscopic Polyangiitis* ; Middle Aged ; Prednisolone ; Renal Insufficiency ; Sepsis ; Sinusitis* ; Tablets ; Thorax ; Tomography, X-Ray Computed ; Vasculitis

Aortic valve is usually involved in infective endocarditis. Aortic valve endocarditis produces destruction and perforation of leaflets and results in ring abscess, frequently. Less commonly, direct extension or infected aortic regurgitant jet can produce secondary involvement of anterior mitral leaflet (AML) and result in the formation of an aneurysm or perforation of AML. A 60-year-old woman was admitted to Kyung Hee University hospital because of a febrile illness and dyspnea. Transthoracic echocardiography (TTE) showed an aortic valve vegetation, an aneurysm of AML, and an eccentric jet of mitral regurgitation through AML. Transe-sophageal echocardiography (TEE) showed a perforation of AML. -streptococcus was isolated from blood culture. The patient was treated with Vancomycin and Sisomicin sulfate. On hospital day 21, heart failure was aggravated and emergent double valve replacement was done. The patient was recovered and discharged.
Abscess ; Aneurysm* ; Aortic Valve* ; Dyspnea ; Echocardiography ; Endocarditis* ; Female ; Heart Failure ; Humans ; Middle Aged ; Mitral Valve Insufficiency ; Sisomicin ; Vancomycin

In order to assess the difference of autonomic dysfunction according to the absence or presence of nephropathy in patients with NIDDM, tests for cardiovascular autonomic function were performed in 23 NIDDM patients without nephropathy(M : F 14 : 9, mean age 50+/- 8) and in 21 patients with nephropathy (M : F 13 : 8, mean age 57+/-12). Tests for cardiovascular autonomic function included the R-R interval changes in response to respiration, Valsalva maneuver, and lying-standing, the blood pressure changes in response to lying-standing and sustained handgrip exercise. The prevalence of autonomic dysfunction was different between the patients without and with nephropathy(69.6% vs 85.7%). For patients without symptoms suggesting autonomic neuropathy, the significant differences were found in the change of R-R interval in response to respiration(22.16+/-21.30 vs 11.73+/-10.83; p=0.0390), in the change of lying-standing blood pressure(10.63+/-9.70 vs 22.00+/-13.67; p= 0.0044) and in the change of blood pressure during handgrip exercise(16.89+/-10.28 vs 8.40+/-7.24; p=0.0065). These results suggested that autonomic neuropathy may occur more frequently in patients with diabetic nephropathy than diabetes mellitus without neuropathy.
Blood Pressure ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diabetic Nephropathies ; Diabetic Neuropathies ; Humans ; Prevalence ; Respiration ; Valsalva Maneuver

BACKGROUND: The aim of this study is to determine prognostic factors of breast cancer in Korean patients who underwent curative mastectomy. METHODS: Medical records of 181 patients who underwent curative mastectomy were reviewed. Relapse-free survival and overall survival were documented for each patient. Factors influencing survival were analyzed using Cox proportional hazard model. RESULTS: Overall 5-year survival rate was 82.0%, and 8-year survival rate was 74.7%. Multivariate analysis indicated that multiple axillary lymph node involvement (> or =4), postmenopausal status, and negative estrogen receptor were independent adverse prognostic factors. The adjusted relative risks of multiple axillary lymph node involvement (> or =4), postmenopausal status, and negative estrogen receptor were estimated 2.60 (95% Confidence Interval (CI): 1.28-5.30), 2.64 (95% CI: 1.46-4.79), and 2.27 (95% CI: 1.19-4.35), respectively. CONCLUSION: Multiple axillary lymph node involvement (> or =4), postmenopausal status, and negative estrogen receptor were independent adverse prognostic factors in Korean breast cancer patients after curative mastectomy.
Breast Neoplasms* ; Breast* ; Estrogens ; Humans ; Lymph Nodes ; Mastectomy ; Medical Records ; Multivariate Analysis ; Proportional Hazards Models ; Survival Rate

PURPOSE: To determine the effects of massage therapy on growth, development, hormones, immune function, hepatic function, hematopoietic function and sleep pattern of preterm infants. METHODS: Thirty-one preterm infants of less than 35 weeks gestational age, who were admitted to Eulji Medical College Hospital Neonatal Intensive Care Unit between August 1998 and May 1999, and were in the state without mechanical ventilation or oxygen therapy, and hemodynamically stable with no acute disease state non congenital anomaly, and who were also fed by oral route or gastric tube, were enrolled in this study. The randomly selected massage group(15 neonates) received three 15-minute periods of tactile and kinesthetic stimulation daily for 7 days, and the control group(16 neonates) received general nursing care. We measured gastrin, thyroid function test, serum cortisol, CH50, IgG, IgM, CBC and liver function test in both groups before and after the study. During observation for 7 days, neonate behaviors were recorded every hour for 10sec using the analysis of 6 sleep-wake states. RESULTS: Although the massage group showed slight differences in blood level of Thyroid stimulating hormone, CH50, hemoglobin, hematocrit and body weight and alertness as compared with control group, there was no statistically significant difference between the two groups. CONCLUSION: Several positive effects of massage on the preterm infants that have been reported previously must be reevaluated.
Acute Disease ; Body Weight ; Gastrins ; Gestational Age ; Hematocrit ; Humans ; Hydrocortisone ; Immunoglobulin G ; Immunoglobulin M ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Liver Function Tests ; Massage* ; Nursing Care ; Oxygen ; Respiration, Artificial ; Thyroid Function Tests ; Thyrotropin

PURPOSE: The clinicopathologic features and prognostic factors of gastrointestinal leiomyosarcoma have been a source of controversy. MATERIALS AND METHODS: A retrospective study was made of 91 incident cases of gastrointestinal leiomyosarcoma from 1979 to 1998 to identify clinicopathologic features and prognostic factors. RESULTS: The median age of study subjects was 56 years and 58.2% was male. Tumors consisted of 2 esophagus, 39 stomach, 38 small bowel, 12 large bowel leiomyosarcoma. Mean size of the tumors was 10.9 cm and 52.9% of them was larger than 10 cm. The tumors were classified as localized stage (42 cases), advanced stage (21 cases), and metastatic stage (28 cases). Again, the tumors were classified as low grade (48 cases) and high grade (18 cases). Median overall survival was 37.4 months and median disease-free survival was 28.2 months. In univariate analysis, the significant factors affecting the overall survival of patients with leiomyosarcoma were stage, size greater than 10 cm, performance status, and histologic grade. In multivariate analysis, stage, performance status, and histologic grade were independent factors affecting the overall survival. In univariate analysis, the significant factors affecting the disease-free survival were stage, performance status, and histologic grade. In multivariate analysis, histologic grade was the only independent factor affecting the disease-free survival. CONCLUSION: Stage, performance status, and histologic grade were independent factors affecting the overall survival. Histologic grade was independent factor affecting the disease-free survival.
Disease-Free Survival ; Esophagus ; Humans ; Korea* ; Leiomyosarcoma* ; Male ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Stomach

PURPOSE: The major aim of this study is to evaluate the patterns of recurrence of the stomach cancer after curative resection. MATERIALS AND METHODS: Patterns of the fimt failure and survival after relapse of 136 female gastric cancer patients who had received curative resection were evaluated. Factors influencing survival after relapse were analyzed using Cox proportional hazard model. RESULTS: Peritoneal relapse was the most common pattern of the first failure, with 3-year estimate of overall peritoneal relapse being 13.0%. The 3-year estimates of overall local- regional relapse, liver metastasis, and extraabdominal relapse were 11.2%, 4.8%, and 3.8%, respectively. Patients younger than 45 years developed peritoneal relapse at a significantly higher rate than patients aged 45-65 years (p 0.037). The most significant factor affecting the survival of relapsed patients was whether resection was performed for recurrent disease without remaining gross residual disease. Patterns of relapse did not significantly affect survival, but patients whose recurrences were limited to local-regional area tended to survive longer than those with extraaMominal component (p=0.067). CONCLUSION: Peritoneal relapse was the most common pattem and significantly associated with younger age after curative resection af gastric cancer of Korean female patients.
Female* ; Humans ; Liver ; Neoplasm Metastasis ; Proportional Hazards Models ; Recurrence ; Stomach Neoplasms*

PURPOSE: To evaluate the activated zone of the supplementary motor area through motor and sensorystimula-tion of both hands by fMRI. MATERIALS AND METHODS: Twenty-four healthy volunteers, ranging in age from 20to 30 years, served as sub-jects. They were divided into four groups and performed one of the four activationtasks : complex movement, fine movement, touch sensation, heat sensation. Complex movement consisted of a fingertask in which sub-jects flexed and extended all fingers repeatedly in union, without the fingers touching eachother(group I). Fine movement involved a thumb task in which subjects flexed and extended the thumb repeatedlywithout touch-ing the other fingers(group II). Touch sensation consisted of a palm task in which another personrepeatedly drew a circle on the subject 's palm (group III), and heat sensation involved of a palm task in whichsubject 's palm was touched by another person with a 40 degreeC water-bag (group IV). F-MRI was conducted on acommer-cial 1.5-T scanner equipped with echo-planar imaging. After overlapping images were obtained using aZ-s-core, and the mean/curve in the MR devices was evaluated, the activated zone of the supplementary motor RESULTS: Thirty-two of 48 images(20 of the 24 men) revealed activated zones in the supplementary motor area. Ingroup I, activation was observed in five subjects, in three of whom it was bilateral (contralateral activation).In group II, activation was observed in five subjects, in one of whom it was bilateral. In group III, activationoccurred in five subjects(bilateral in four, and contralateral in three), and In group IV, activation was alsoob-served in five ; in three of these it was bilateral. CONCLUSION: Using fMRI, and in association with motor andsensory tasks, the supplementary motor area was activated in 66.7% of healthy volunteers (32/48).
Brain* ; Echo-Planar Imaging ; Fingers ; Hand ; Healthy Volunteers ; Hot Temperature ; Humans ; Magnetic Resonance Imaging* ; Sensation ; Thumb