Lymphangioma involving whole mesentery confirmed by core needle biopsy / 영남의대학술지

Lymphangiomas are malformations of the lymphatic system accounting for approximately 5% of all benign tumors in infants and children. Abdominal lymphangiomas are rare, and can arise from either the retroperitoneum, gastrointestinal tract, or the mesentery of the abdominal viscera. Lymphangioma involving the whole mesentery is particularly rare. Most lymphangiomas are detected during infancy or childhood, but intraabdominal lymphangiomas such as mesentery are not found until adulthood. We report here on a patient with uncommon lymphangioma involving the whole mesentery who presented with fever and abdominal pain. This patient is unusual because he was confirmed through core needle biopsy which showed variable sized lymphatic spaces representing a immunoreactive for D2-40 antibody with involvement of the whole mesentery. No cases of mesenteric lymphangioma confirmed preoperatively have been previously reported in Korea.

A Case of Chronic Myeloid Leukemia with Multiple Chloromas Treated Successfully with Dasatinib / 계명의대학술지

Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder of the primitive hematopoietic stem cells. CML is characterized by the overproduction of myeloid cells, which results in marked splenomegaly and leukocytosis. CML presented by multiple chloromas is extremely rare. Multiple chloromas in the skin and brain are quite rare as the initial presentation of CML. These rare manifestation should alert clinicians to include CML in the differential diagnosis of patients presenting with multiple non-pruritic skin nodules or neurologic symptoms. Dasatinib has promising therapeutic potential for managing intracranial leukemic disease. Here, we report the case of a patient who visited the hospital with multiple chloroma which is unusual presentation of CML, and treated with dasatinib successfully.

Comparative binding of antitumor drugs to DNA containing the telomere repeat sequence

Telomeres are the ends of the linear chromosomes of eukaryotes and consist of tandem GT-rich repeats in telomere sequence i.e. 500-3000 repeats of 5'-TTAGGG-3' in human somatic cells, which are shortened gradually with age. The G-rich overhang of telomere sequence can adopt different intramolecular fold-backs and tetra-stranded DNA structures, in vitro, which inhibit telomerase activity. In this report, DNA binding agents to telomere sequence were studied novel therapeutic possibility to destabilize telomeric DNA sequences. Oligonucleotides containing the guanine repeats in human telomere sequence were synthesized and used for screening potential antitumor drugs. Telomeric DNA sequence was characterized using spectral measurements and CD spectroscopy. CD spectrum indicated that the double-stranded telomeric DNA is in a right-handed conformation. Polyacrylamide gel electrophoresis was performed for binding behaviors of antitumor compounds with telomeric DNA sequence. Drugs interacted with DNA sequence caused changes in the electrophoretic mobility and band intensity of the gels. Depending on the binding mode of the anticancer drugs, telomeric DNA sequence was differently recognized and the efficiency of cleavage of DNA varies in the bleomycin-treated samples under different conditions. DNA cleavage occurred at about 1% by the increments of 1 mM bleomycin-Fe(III). These results imply that the stability of human telomere sequence is important in conjunction with the cancer treatment and aging process.

The usefulness of electrocardiographic T axis for the diagnosis of acute myocardial ischemia

BACKGROUND: Electrocardiographic variables such as changes in the ST-T segment, and increased QT interval have been found to predict the occurrence of myocardial ischemia. But disadvantages of most of these variables have poor reproducibility and require analysis of all ECG leads. If electrocardiographic T axis properly predicts myocardial ischemia, it can be used as a useful marker for diagnosing myocardial ischemia in primary practice. METHODS: We selected 147 persons, who visited the emergency room or an outpatient clinic because of chest pain, in whom coronary angiography was performod. We reviewed their medical records. Electrocardiographic T axis was classified as normal, borderline and abnormal T axis. We identified the relation between cardiovascular risk factors and electrocardiographic T axis, and also, the relation between ischemic electrocardiographic variables and T axis. We examined the relation between coronary angiographic results and electrocardiographic T axis. RESULTS: The sensitivity and specificity of electrocardiographic T axis was 26.7% and 86.9%, respectively. The positive predictive value and negative predictive value was 81.8% and 35.1%, respectively. The proportion of hypertension was 41.2% in normal T axis group, 65.5% in borderline T axis group, and 34.4% in abnormal T axis group, which was statistically significant (P=0.032). The relation between coronary angiographic results and electrocardiographic T axis was not statistically significant. The subjects with abnormal T axis were associated with ST depression (P=0.016). CONCLUSION: The T axis abnormality was not useful for screening myocardial ischemia, but it was useful to rule out other diseases due to its high specificity.

Family physicians'concept of 'neurotic'as a medical terminology

BACKGROUND: A good doctor-patient relationship should be based on mutual understanding and reliance. Proper conversation and same understanding of the use of this terminology is needed. This study was designed to make a comerstone to establish appropriate medical terminology by means of investigation of the meaning of 'neurotic' among family' physicians. METHOD: A questionnaire was sent to 971 family doctors registered as regular members in the Korean Academy of Family Medicine. We analysed 184 returned questionnaires. We calculated the percent for each item. Chi-square test used to analyse demographic characteristics and compare whether the word 'neurotic' has been used or not, and whether it was a proper medical terminology or not. RESULT: 82.6% of responders(152/184) were used to 'neurotic' as a medical terminology. Doctors in their thirties were the least using group(78.7%) and doctors working in university hospitals rarely used them being statistically significant (p<0.000). 82.5% of the doctors in using 'neurotic' responded it is not an appropriate terminology. The most frequent situation in using it was 'patient appealed organic symptom without abnormal lab result'(51.1%). The target diseases were not organic disorders such as functional dyspepsia(64.1%), tension headache(58.5%), psychosomatic or somatoform disorder(54.9%). 59% of the patients diagnosed as 'neurotic' gave unsatisfying responses. Family doctors recommended substituting to terminology such as 'functional'(33%), 'psychogenic'(31.8%), and 'stress-induced'(25.0%). CONCLUSION: Most family doctors were used to the word 'neurotic' but they did not think it was an appropriate terminology. There fore, other substitute words should be faken into consideration.