Ascending Colon Cancer with Pathologically Confirmed Tumor Thrombosis of Superior Mesenteric Vein: A Case Report

Colon cancer is very rarely accompanied by tumor thrombosis of the superior mesenteric vein (SMV). A 46-year-old patient had been diagnosed with SMV tumor thrombosis related to colon cancer without hepatic metastasis and underwent right hemicolectomy with SMV tumor thrombectomy. Tumor thrombosis was pathologically confirmed as metastatic colon cancer. There has been no recurrence for 12 months with 12 cycles of adjuvant-chemotherapy.

The Behcet't Disease Quality of Life: Reliability and Validity of the Korean Version

PURPOSE: The Behcet's Disease Quality of Life (BD-QoL) is a BD-specific measure developed in the UK. The aim of this study was to adapt the BD-QoL for use in Korea. PATIENTS AND METHODS: The translation was based on the guidelines for cross-cultural adaptation. A total of 201 Korean patients with BD participated in this study. To evaluate the psychometric properties, internal consistency and test-retest reliability were used. Factor analysis was performed to examine the construct validity. To provide further evidence for validity, the correlation of BD-QoL with the Clinical Activity Form for Korean Patients with BD (BDCAF-K) and the Center for Epidemiologic Studies-Depression (CES-D) scales was assessed. RESULTS: The Korean version had high internal consistency (Cronbach's alpha, 0.93) and test-retest reliability (r = 0.835). Factor analysis of the questionnaire revealed one interpretable factor as a general health-related quality of life factor. The Korean version significantly correlated with scores of CES-D (r = 0.749, p = 0.000), self-rating scale of well-being over the past 28 days (r = 0.446, p = 0.000), and BDCAF-K score (r = 0.502, p = 0.000). CONCLUSION: Adaptation of the BD-QoL for use in Korea was successful. Together with the BDCAF-K, it may be a valuable tool for assessing the influence of interventions in BD patients and outcome in clinical trials.

A Case of Multiple Basaloid Follicular Harmatoma / 대한피부과학회지

Basaloid follicular hamartoma (BFH) is a benign adnexal tumor with a wide spectrum of clinical appearance and is characterized histologically by the presence of branching cords and thin strands of undifferentiated anasomosing, basaloid proliferations that are embedded in a fibrous stroma. We report the case of a 4-year-old boy with multiple BFH. To our knowledge, this is the first case report of multiple BFH in the Korean literature.

Altered Expression of c-Jun, Bcl-2 and Bax, and Apoptotic Cell Death in Rat Hippocampus Following Kainic Acid-Induced Seizures / 대한간질학회지

PURPOSE: To investigate whether c-Jun, Bcl-2 and Bax expressions are altered in rat hippocampus after kainic acid (KA)-induced seizures, and to determine whether such changes correlate with apoptotic cell death. METHODS: Forty male Sprague-Dawley rats were used. Thirty rats were assigned to the experiment group, and 10 rats the control. KA (20 mg/kg) was injected once intraabdominally. The behavioral patterns were observed after the injection. The rats' brain was extracted 4, 24, and 72 hours after KA injection. c-Jun, Bcl-2 and Bax expression were evaluated by immunohistochemistry, and apoptosis by TUNEL staining. The expression of c-Jun, Bcl-2 and Bax at each hippocampal region were compared, and the relationship between c-Jun, Bcl-2 and Bax expression, and apoptosis was investigated. RESULTS: c-Jun expression was increased at CA1, CA3 and CA4 regions 4 hours after the injection, and the increased expression was continued to 72 hours at CA3 region. Bcl-2 expression was increased at CA1, CA3 and CA4 regions 4 and 24 hours after the injection, and the increased expression was continued to 72 hours at CA3 region. Bax expression was increased at CA3 and CA4 regions 4 hours after KA injection, and the increased expression was continued to 72 hours at CA3 region. Apoptosis was significantly increased at CA3 region 4 hours after KA injection. CONCLUSION: c-Jun expression was increased in hippocampus after KA-induced seizures, and cell death-regulating proteins Bcl-2 and Bax expression, and apoptosis were increased at similar regions. These results suggest that c-Jun might be activated in KA-induced apoptotic cell death mechanism.

Erythema Nodosum: Clinicopathologic Correlations and Their Use in Differential Diagnosis

PURPOSE: Typically, a diagnosis of erythema nodosum (EN) is based on clinical features. However, other diseases manifest with inflammatory nodules of the lower limbs in addition to EN, such as the EN-like lesions of Behcet's disease (BD). The purpose of this retrospective study was to investigate the frequency of histologically proven EN among diseases diagnosed clinically as EN, to determine underlying causes of EN, and to compare clinical and histologic features between EN and other diseases. PATIENTS AND METHODS: We selected 99 patients diagnosed clinically with EN and performed skin biopsies. All pathologic slides were evaluated and diagnosed; and after histologic diagnoses were made we reviewed the patients' medical records. RESULTS: Among the 99 patients diagnosed clinically with EN, 47 were biopsy-verified EN. The EN-like lesions of BD and nodular vasculitis were both in the primary differential diagnosis of EN. No definite difference in clinical features exists among these three diseases. Histologically, EN demonstrated septal panniculitis in the majority of patients. Lobular panniculitis was frequently observed in NV, and mixed or mostly lobular panniculitis was observed in the EN-like lesion. Vasculitis was rarely observed in EN; however lymphocytic vasculitis was observed frequently in EN-like lesions and neutrophilic vasculitis was observed in NV. The frequency of granulomatous inflammation was highest in NV. Some cases of patients with typical BD demonstrated classic EN lesions. CONSLUSION: It was extremely difficult to clinically differentiate EN from EN-like lesions or NV. We feel skin biopsy is mandatory for the diagnosis of lower extremity erythematous nodular lesions.

Two Cases of Holmes-Adie Syndrome

BACKGROUND: Adie's tonic pupil consists of mydriasis, accommodation defect, decreased light reflex, and tonic near reflex. When tonic pupil is combined with hypo- or areflexia, it is called Holmes-Adie syndrome. CASE: Fifty-two-year-old and 37-year-old female patients showed unilateral dilated irregular pupil, decreased light reflex, and decreased or absent DTR. When 0.125% pilocarpine was dropped on the dilated pupil, the pupil was constricted after pilocarpine application. Somatosensory evoked potentials were within normal ranges, and H-reflex responses were absent or delayed.

Occipital lobe seizure due to hypertensive encephalopathy in youth

BACKGROUND & OBJECTIVES: Hypertensive encephalopathy is an acute neurologic syndrome characterized by abrupt and marked elevation of blood pressure, headache, vomiting, seizure, visual disturbance, and altered mental status. This syndrome may occur as a complication of toxemia, renal artery stenosis and acute glomerulonephritis. We report 4 young patients with occipital lobe seizure, as a presenting sign of hypertensive encephatopathy, whose brain MRI and perfusion scans showed lesions on bilateral occipital lobes. Case : Four young patients experienced moderate to severe headache, visual illusion, generalized seizure, and loss of sight for a few days. Their systolic blood pressure was 150-170mmHg and diastolic blood pressure 100-120mmHg. Three patients had proteinuria and hematuria as the results of acute glomerulonephritis. CSF findings were within normal limits. EEG showed intermittent generali,ed or bilateral temporoparietooccipital slowings in all patients and continuous parietooccipital slowings in one patient. Brain MRI man showed hyperintensity signal in T2WI and hypointensity signal in TlWl on bilateral occipital lobes and SPECT scan showed normal perfusion three patients and increased perfusion on occipital areas in one patient. They were treated with antihypertemsive agents and anticonvulsants (phenobarbital or valporic acid) for 2-10 months. Seizure was well controlled and didn't recur though discontinuing anticonvulsant. CONCLUSION: In young age, acute hypertension may cause clinically occipital lobe seizure and radiologically bilateral occipital lobe lesions.

A case of wilson's disease showing palialia as an initial symptom

Wilson's disease is an autosomal recessive disorder resulting from an excessive accumulation of copper in the liver, cornea, kidneys, and in the basal ganglia of the brain. The prominent speech disturbances of Wilson's disease include monopitch, monoloudness, slow rate, low pitch, delayed in initiating speech and rarely palilalia. A19-year-old woman developed palilalia which was characterized by compulsive repetition of a phrase with increasing rapidity and with a decrescendo of voice volume. Although she had been suffering from liver cirrhosis for the past 8 months, the palilalia was the only neurological sign at initial examination. She showed a low serum ceruloplasmin, low serum copper, increased urinary copper excretion, and Kayser-Fleischer rings. Brain magnetic resonance images showed high signals in the bilateral basal ganglia in T2-weighted images, and slight cortical atrophy.