Sex cord tumor with annular tubules (SCTAT) is a rare ovarian neoplasm which usually occurs in two forms. In patients associated with Peutz-Jeghers syndrome, the tumors are usually small, bilateral or multifocal, and show benign clinical course. However, tumors from patients without the syndrome are often large, usually unilateral, and rarely show malignant behavior. Serous surface papillary carcinoma (SSPC) is an aggressive neoplasm which involves peritoneal linings, including ovarian surface. Recently, we encountered a case of an unusual combination of SCTAT and SSPC in the ovary of a 55-year-old Korean woman presented with abdominal distention for one year. Systemic review and physical examination were within normal limit, except for abdominal discomfort and distention. There was no stigmata of Peutz-Jeghers syndrome in all diagnostic examinations, including gastroscopy and colonoscopy. Pelvic computed tomography showed adnexal mass with multiple peritoneal nodules. Exploration revealed uterine and ovarian surfaces covered with multiple, yellow-white papillary nodules. However, the sizes of both ovaries were within normal limit. Typical serous papillary carcinomas were identified in nodules from peritoneum and ovarian surfaces. Well-circumscribed columnar epithelial cell nests composed of ring-shaped tubules encircling hyalinized basement membrane-like materials were found in the ovary away from serous surface papillary carcinoma.
Carcinoma, Papillary* ; Christianity ; Colonoscopy ; Epithelial Cells ; Female ; Gastroscopy ; Humans ; Hyalin ; Middle Aged ; Ovarian Neoplasms ; Ovary* ; Peritoneum ; Peutz-Jeghers Syndrome ; Physical Examination

Background: Thyroperoxidase(TPO) is one of the most important autoantigens in autoimmune thyroid disorders and autoantibody to TPO is found in almost every patients with various autoimmune thyroid diseases. Human TPO was already cloned and the completed nucleotide sequences are well known. In human thyroid tissues, several variants mRNA's of TPO are found in addition to the wild type. Especially the variants lacking exon 10(TPOΔexon10) and exon 16(TPOΔ exon16) are found in very large amount in both normal and Graves thyroid tissues. The significance of these variants TPO mRNAs are largely unknown. The authors tried to investigate the autoantigenic role of these variant TPO. Methods : To produce variant TPO cDNAs, oligonucleotide directed mutagenesis was performed using cDNA for wild type human TPO as template. The produced variants cDNAs were transfected into Cos-7 cells and variants TPO proteins were tested against patients sera showing high titers of anti-TPO antibody. Results: Seven of 12 Graves sera reacted with TPOΔexon 10 and 8 Graves sera with TPOΔ exonl6. Eight of 15 Hashimoto sera reacted TPOΔexon16 and 9 with TPOΔexon16. The reactivity with variants TPO was not related to clinical findings. Conclusion: These two variant TPOs, that is TPOexon10 and TPOΔexon16, could act as an autoantigen if they were translated in vivo, and could play a role in autoimmune thyroid disease. Their exact role in the pathogenesis of autoimmune thyroid disorders are to be clarified.
Animals ; Autoantigens ; Base Sequence ; Clone Cells ; COS Cells ; DNA, Complementary ; Exons ; Humans ; Mutagenesis, Site-Directed ; RNA, Messenger ; Thyroid Diseases ; Thyroid Gland

Ossification of the ligamentum flavum (OLF) has been recognised as a definite clinical entity as an ossification of the posterior longitudinal ligament. It has been known that the incidence of OLF is high in Japan and OLF usually occurs in the thoracic and lumbar region. Recently OLF has received considerable attention as a cause of myelopathy. OLF is quite distinct from “hypertrophy” of the ligamentum flvum. We experienced 2 cases of OLF with neurological symptom, which were treated by decompressive laminectomy and removal of the ossified ligamentum flavum. So remarkable symptomatic improvement was obtained.
Incidence ; Japan ; Laminectomy ; Ligamentum Flavum ; Longitudinal Ligaments ; Lumbosacral Region ; Spinal Cord Diseases ; Spine

No abstract available.
Female ; Labor, Induced* ; Pregnancy*

A 51-year-old woman was presented with a palpable mass in the infraauricular area that had existed for 4-months. The mass from the superficial lobe of the parotid gland was 2.7 cm in the greatest dimension and was ill-defined with rubbery, homogeneous, and fibrotic appearance. Histologically, the lesion was infiltrative into the lobules of the paratid gland, and was composed of a proliferation of spindle or stellate cells with cellular and sclerotic areas. On immunohistochemistry, the cells were only positive for vimentin and focally for smooth muscle actin. Differential diagnosis from nerve sheath tumors and solitary fibrous tumors involving the parotid gland was emphasized.
Actins ; Diagnosis, Differential ; Female ; Fibroma* ; Humans ; Immunohistochemistry ; Middle Aged ; Muscle, Smooth ; Nerve Sheath Neoplasms ; Parotid Gland* ; Solitary Fibrous Tumors ; Vimentin

Liver biopsies are used routinely in the assessment of graft dysfunction following liver transplantation and generally considered to be the most reliable method for the diagnosis of posttransplant complications with overlapping clinical and laboratory findings. To investigate posttransplant complications causing graft dysfunction and usefulness of liver biopsy, we analysed clinicopathologic features of 65 posttransplant liver biopsies, 2 autopsies and an explanted liver, taken from 20 patients. The frequencies of posttransplant complications were acute cellular rejection in 9 patients (45%), postoperative infection in 11 patients (55%), of which cytomegalovirus (CMV) infection and systemic invasive aspergillosis with candidiasis occured in 10 patients (50%) and 1 patient (5%), respectively. Remainders were hepatic arterial thrombosis in two (10%), primary graft dysfunction due to fatty donor liver in one (5%), and posttransplant lymphoproliferative disorder (PTLD) in two (10%). There were no chronic rejection or recurrent disease. Postoperative mortality was 25%. Histologic grade by Banff schema was well correlated with clinical parameters associated with unfavorable short term prognosis. CMV infection was associated with acute cellular rejection in 6 out of 10 patients (60%). Immunohistochemical staining for CMV was more sensitive method than CMV in situ hybridization or histologic detection of viral inclusion on tissue section. It was unique that one case of PTLD developed under the circumstances of the lowest dosage of immunosuppression and took grave outcome. Based on these results, we concluded that clinicopathologic correlation with integration of all the clinical and laboratory findings is necessary in the interpretation of accurate and early diagnosis of posttransplant liver biopsies. The interrelationship between chronic rejection and CMV infection as well as pathogenetic factors of PTLD remains to be clarified through further ongoing observation.
Aspergillosis ; Autopsy ; Biopsy* ; Candidiasis ; Cytomegalovirus ; Diagnosis ; Early Diagnosis ; Humans ; Immunosuppression ; In Situ Hybridization ; Liver Transplantation ; Liver* ; Lymphoproliferative Disorders ; Mortality ; Primary Graft Dysfunction ; Prognosis ; Thrombosis ; Tissue Donors ; Transplants

No abstract available.
Foot* ; Hand*

BACKGROUND: CD34 positive cell enumeration by flow cytometry is currently used to determine the optimal timing of peripheral blood stem cell collections (PBSC) and to predict engraftment of stem cell transplantation. However, the technical problems and lack of a standardized method are sources of significant variability in the quantitation of the CD34 positive cells. ProCOUNT(TM) (Beckon Dickinson Immuno- cytometry System, USA) kit for three color flow cytometric analysis was introduced to enumerate CD34 positive cells using a standardized method. This study was conducted to evaluate the usefulness of the three color method, ProCOUNT(TM), in comparison with two color method. METHODS: CD34 positive cells from 25 cord blood samples were enumerated by two methods, two color (CD34-PE/CD45-FITC) and three color (ProCOUNT(TM) , nucleic acid dye/CD34-PE/ CD45-PerCP) flow cytometric analysis, in which CD34 positive cells were counted directly in comparison with counting beads introduced in the sample. RESULTS: The count of CD34 positive cells in the cord blood was 28.3(+/-20.0)/uL and 20.9 (+/-16.0) /uL by three color and two color methods, respectively, The number of CD34 positive cells enumerated by ProCOUNTTM kit was well correlated with that by two color method, but the count was significantly higher in the former method (p<0.01). CONCLUSIONS: In the three color method, loss of stem cells was significantly lower than that in the two color method, and it was possible to obtain a direct count of CD34 positive cells by using a standardized procedure.
Fetal Blood* ; Flow Cytometry ; Hematopoietic Stem Cells* ; Stem Cell Transplantation ; Stem Cells

BACKGROUND: CD34 positive cell enumeration by flow cytometry is currently used to determine the optimal timing of peripheral blood stem cell collections (PBSC) and to predict engraftment of stem cell transplantation. However, the technical problems and lack of a standardized method are sources of significant variability in the quantitation of the CD34 positive cells. ProCOUNT(TM) (Beckon Dickinson Immuno- cytometry System, USA) kit for three color flow cytometric analysis was introduced to enumerate CD34 positive cells using a standardized method. This study was conducted to evaluate the usefulness of the three color method, ProCOUNT(TM), in comparison with two color method. METHODS: CD34 positive cells from 25 cord blood samples were enumerated by two methods, two color (CD34-PE/CD45-FITC) and three color (ProCOUNT(TM) , nucleic acid dye/CD34-PE/ CD45-PerCP) flow cytometric analysis, in which CD34 positive cells were counted directly in comparison with counting beads introduced in the sample. RESULTS: The count of CD34 positive cells in the cord blood was 28.3(+/-20.0)/uL and 20.9 (+/-16.0) /uL by three color and two color methods, respectively, The number of CD34 positive cells enumerated by ProCOUNTTM kit was well correlated with that by two color method, but the count was significantly higher in the former method (p<0.01). CONCLUSIONS: In the three color method, loss of stem cells was significantly lower than that in the two color method, and it was possible to obtain a direct count of CD34 positive cells by using a standardized procedure.
Fetal Blood* ; Flow Cytometry ; Hematopoietic Stem Cells* ; Stem Cell Transplantation ; Stem Cells

BACKGROUND: Essential tremor is one of the most common types of movement disorders. Although it is sometimes prefaced with the term 'benign', it often causes significant disabilities. Clinical characteristics and responses to various drugs have not been investigated systematically in Korea. Therefore, we studied the clinical features, electrophysiologic findings, and drug responsiveness of essential tremor. METHODS: Forty-five patients were included in the study by clinical criteria for essential tremor. We investigated their clinical features including tremor type, involved sites, family history, and responsiveness to alcohol. We used an electromyography study to evaluate the contraction patterns between agonist and antagonist muscles and the frequency of tremor. Primidone and propranolol were prescribed to all the patients (N=30) with a sufficient washout period (more than 2weeks) for drug responsiveness. Drug responsiveness was estimat-ed with self-assessment scales. RESULTS: The mean age of patients at the onset of the tremor was 45 years and the average duration of the tremor was 11.1 years. Kinetic tremor was dominant in 17 patients (37.8%) and postural tremor in 28 patients (62.2%). Family history was found in 18 patients (40%) and alcohol reduced tremors in 18 (64.8%) out of 28 patients with sufficient alcohol intake. Co-contraction was seen in 18 patients (40%), alternative contraction in 15 (33.6%), and mixed contraction in 3 (6.7%). Mean frequency was 6.7 Hz. Propranolol reduced tremor in 24 patients (80%), and primidone in 27 patients (90%). CONCLUSIONS: It was concluded that essential tremor was heterogenous clinically and electrophysiologically. Primidone was found more effective than propranolol in reducing tremor.
Electromyography ; Essential Tremor* ; Humans ; Korea ; Movement Disorders ; Muscles ; Primidone ; Propranolol ; Self-Assessment ; Tremor ; Weights and Measures