Alveolar Soft Part Sarcoma Arising from the Kidney: Imaging and Clinical Features

Alveolar soft part sarcoma (ASPS) is an extremely rare malignant soft tissue sarcoma primarily affecting young patients. It usually occurs in the lower extremities, although it can occur in soft tissue anywhere in the body. However, to our knowledge, there has been no case of primary ASPS originating from the kidney in the literature. We herein present the imaging and clinical features of an ASPS which occurred in a 16-year-old male presented as a palpable mass in the left side of the abdomen.

Prenatal detection of skeletal dysplasia using ultrasound and molecular diagnosis / 대한산부인과학회지

OBJECTIVE: To determine the accuracy and usefulness of prenatal ultrasonographic and molecular genetic diagnosis in detection of skeletal dysplasia. METHODS: This study was based upon data of the 17 cases of skeletal dysplasia diagnosed by prenatal ultrasound and 7 cases by molecular diagnosis performed among the 17 cases and the 2 cases who has familial skeletal dysplasia by molecular diagnosis during the first trimester at Ewha and Eulji University from March 1998 to August 2005. A final diagnosis was sought on the basis of radiographic studies, molecular testing, or both. RESULTS: The mean gestational age at diagnosis was 24.9 weeks (range, 17 to 35 weeks). Nine cases were diagnosed before 24 weeks. A final diagnosis was obtained in 16 cases (94.1%). There was 1 false-positive diagnosis. The antenatal diagnosis was correct in 14 cases (82.4%). The 8 cases were prenatally confirmed and 1 case was postpartum confirmed using molecular genetic testing and accurate antenatal diagnosis and prediction was done. We were able to rule out skeletal dysplasia through chorionic villus sampling during the first trimester in the 2 cases with the family history with skeletal dysplasia. CONCLUSION: Prenatal diagnosis of skeletal dysplasia can be a considerable diagnostic challenge. However, skeletal dysplasia is correctly diagnosed on the basis of prenatal meticulous ultrasound and antenatal prediction of lethality was highly accurate. Using prenatal molecular diagnosis, skeletal dysplasia can be diagnosed at first trimester of pregnancy and nonlethal skeletal dysplasia can be confirmed when prenatal ultrasound was nonspecific.

Association of preterm birth with IFN-gamma, IL-10, and CYP 1A1 gene in Korean women / 대한산부인과학회지

OBJECTIVE: To investigate the association between preterm birth and cytokine genes (IFN-gamma, interleukin (IL)-10) in intrauterine infection and enzyme gene (CYP1A1) in oxidative stress response. METHODS: This study involved a case-control study conducted at Ewha Womans University Hospital in Seoul, Korea. Subjects with preterm deliveries ( or =37 weeks of gestation) were selected from gravidas who had undergone prenatal examinations in the hospital and were followed until infant delivery. The weight, height, and blood samples of each participants were obtained according to standard protocols. We included subjects who gave birth to a singleton infant and had a gestational age between 24 and 42 weeks. Mutiple births, stillbirths, and congenital anomalies were excluded. Finally, 164 gravidas with preterm births and 305 normal controls with term deliveries were enrolled in the present study. RESULTS: Preterm delivery group and term delivery group had significant difference in gestational age and neonatal body weight (P0.05). CONCLUSION: In this study, IFN-gamma (874A/T), IL-10 (1082A/G), IL-10 (819C/T), IL-10 (592A/C) and CYP1A1 (T6235C), CYP1A1 (Ile462val [A/G]) genes had no significant association with preterm birth.

Chlamydia pneumoniae(Cp) infection, is that a risk factor of atherosclerosis?: On the basis of seroepidemiologic study / 대한내과학회지

BACKGROUND: Several risk factors of atherosclerosis have been known. However, many patients have been experienced coronary heart disease without known risk factors of atherosclerosis, and it has been suggested that some kinds of infections may be associated with atherosclerosis as risk factors. Among many candidate infectious agents, Chlamydia pneumoniae (Cp) has been showing a positive relationship with atherosclerosis. Therefore, we investigated massive serologic study using a ELISA for detection of Cp to identify the relationship with atherosclerosis as a risk factor. METHODS: Serologic tests were done in patients who were performed coronary angiogram among patients with typical symptoms of angina and with positive results in non- invasive test (EKG, Treadmill) from May 1997 to September 1998. Among them, patients with luminal narrowing of more than 50% in at least one vessel were grouped into 'Case group (Group I)' and patients with normal coronary arteries or minimal lesion were grouped into 'Positive control group(Group II)'. We also studied healthy persons, as a 'Negative control group (Group III), who had not experienced any symptoms related with coronary heart disease and had normal EKG findings. Serologic tests for Cp-IgG and Cp-IgA were performed by ELISA. RESULTS: There was no statistical difference in seropositive rate between Group I and II, but seropositive rate of Group III was statistically lower than those of Group I or II for Cp-IgG, Cp-IgA, and both, respectively. But multivariate analysis by using logistic regression showed no statistcal differences between groups. Subgrouping by several traditional risk factors, seropositive rate for Cp-IgG and both IgG and IgA, was significantly different between Group I and III in patients without traditional risk factors of atherosclerosis, such as, females, non-smokers, normotension, non-diabetes, normal cholesterol level, and high HDL-cholesterol level. For Cp-IgA, however, the difference was observed in normotension, non-diabetes, and in normal cholesterol level. In multivariate analysis, seropositive rate for Cp-IgG and both IgG and IgA was significantly different between Group I and III in females and non-smokers, but not for the Cp-IgA. CONCLUSIONS: These results suggest that Cp infection might be an independent risk factor of atherosclerotic coronary disease, particularly in patients without traditional risk factors of atherosclerosis. Further study with coronary tissue should be continued.

Clinical Evalution of the Incidence and Outcome of Patient with Fungemia / 감염

BACKGROUND: Fungus is the common pathogen of nosocomial infection, and the 4th common pathogen of nosocomial bloodstream infection. We evaluated the annual occurrence, the relation between fungemia and central venous catheter-related infection, the risk factors and survival rate of fungemia. METHODS: We reviewed medical record of 209 cases with fungemia occurred in the period of from 1992 to 1997 in Severance hospital retrospectively. RESULTS: The annual occurrence of nosocomial fungemia was 3.9, 6.7, 6.7, 7.8, 13.6, 8.0, per 10,000 patient discharges in 1992, 1993, 1994, 1995, 1996, 1997. The species of fungemia wete Candida albicans (47.79o), C. glabrata (12.1%), C. parapsilosis (11.7%), C. tropicalis (11.2/o), C. guilliermondii (1.9fo), C. krusei (1.9%), Rhodotorula species (2.3%), Trichosporon species (1.9%), molds (4.7%). The proportion of definite catheter-related bloodstream infection was 41.6%, probable catheter-related bloodstream infection 28.2%, and the fungemia that was not related with central venous catheter infection was 30.1%. Mortality rate of fungemia was 53.6%, and median survival days were 29 days. Catheter removal and antifungal therapy increased survival rate, but persistent fungemia and thrombocytopenia were poor prognostic factors. CONCLUSION: The fungal bloodstream infection is increased and high proportion of fungemia is related to central venous catheter-related infection. Since catheter removal and antifungal therapy have benefit on survival rate, early evaluation of catheter-related infection and antifungal therapy in fungemia patient is recommended.