Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carcinomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas (67%) and 7 papillomas (58%). Single cells were present in 5 carcinomas (83%) and 8 papillomas (67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas (67%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor
Breast ; Carcinoma, Papillary ; Central Nervous System* ; Cyclosporine* ; Epithelial Cells ; Macrophages ; Metaplasia ; Needles ; Papilloma ; Papilloma, Intraductal ; Retrospective Studies

A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2.- The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%) mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), Typel membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) .and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.
Biopsy* ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Internal Medicine ; Male ; Nephrotic Syndrome ; Peptidyl-Dipeptidase A

Traumatic dislocation of the peroneal tendon is an infrequent injury. This injury is caused by forceful dorsiflexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior peroneal retinaculum and allows the tendons to snap anteriorly. We experienced a case of chronic recurrent dislocation of the peroneal tendon, which was treated by bone block surgery using autograft of lateral fibula and reattachment of the superior peroneal retinaculum. The clinical result was satisfactory.
Autografts ; Dislocations* ; Fibula ; Foot ; Muscles ; Tendons*

OBJECTIVE: We evaluated the effects of tooth displacement on frictional force when conventional ligating lingual brackets (CL-LBs), CL-LBs with a narrow bracket width, and self-ligating lingual brackets (SL-LBs) were used with initial leveling and alignment wires. METHODS: CL-LBs (7th Generation), CL-LBs with a narrow bracket width (STb), and SL-LBs (In-Ovation L) were tested under three tooth displacement conditions: no displacement (control); a 2-mm palatal displacement (PD) of the maxillary right lateral incisor (MXLI); and a 2-mm gingival displacement (GD) of the maxillary right canine (MXC) (nine groups, n = 7 per group). A stereolithographic typodont system and artificial saliva were used. Static and kinetic frictional forces (SFF and KFF, respectively) were measured while drawing a 0.013-inch copper-nickel-titanium archwire through brackets at 0.5 mm/min for 5 minutes at 36.5℃. RESULTS: The In-Ovation L exhibited lower SFF under control conditions and lower KFF under all displacement conditions than the 7th Generation and STb (all p < 0.001). No significant difference in SFF existed between the In-Ovation L and STb for a 2-mm GD of the MXC and 2-mm PD of the MXLI. A 2-mm GD of the MXC produced higher SFF and KFF than a 2-mm PD of the MXLI in all brackets (all p < 0.001). CONCLUSIONS: CL-LBs with narrow bracket widths exhibited higher KFF than SL-LBs under tooth displacement conditions. CL-LBs and ligation methods should be developed to produce SFF and KFF as low as those in SL-LBs during the initial and leveling stage.
Friction* ; Incisor ; Ligation ; Saliva, Artificial ; Tooth*

We experienced a case of Plasmodium falciparum gametocytemia successfully treated with primaquine in a twenty seven-years old woman. The patient had been admitted due to general malaise after diagosis and treatment of P. falciparum at Tanzania one month ago. On microscopic examination, P. falciparum gametocytemia was seen and treated with mefloquine for one week but gametocytemia was not disappeared. After primaquine treatment for two weeks, she was successfully treated.
Female ; Humans ; Mefloquine ; Plasmodium falciparum* ; Plasmodium* ; Primaquine* ; Tanzania

Unilateral localized hyperhidrosis over scalp and face is an extremely rare disease that usually has undetermined origin. We report a case of idiopathic unilateral localized hyperhidrosis over left scalp and face. A 55-year-old female patient with unilateral hyperhidrosis that is localized in the left side of scalp and face visited our dermatology clinic. She had increased sweating in left face and scalp, recurring in summer for 3 years. She complained of the exacerbation by thermal and gustatory stimuli and exercise. The starch iodine test and digital infrared thermal imaging test revealed a marked increase in sweat gland activity on the affected areas as compared to the contralateral normal sites.
Dermatology ; Female ; Humans ; Hyperhidrosis* ; Iodine ; Middle Aged ; Rare Diseases ; Scalp* ; Starch ; Sweat ; Sweat Glands ; Sweating

BACKGROUND: Vimentin is the major intermediate-size filament in the cytoplasm of cells from mesenchymal origin. The HL-60 cell is a unique human leukemic cell line capable of terminal differentiation with several chemical inducers, and then the cell line becomes a fre#quently described model system for cell differentiation in vitro. Vimentin mRNA is reduced during all-trans retinoic acid (retinoic acid) -dependent differentication but increased by 12-0-tetradecanoylphorbol-13-acetate (TPA). In this paper, we have investigated on the mechanism of transcriptional repression of vimentin gene during retinoic acid-dependent differentication of HL-60 cell. METHODS: HL-60 cells were grown in RPMI 1640 medium supplemented with 10% heat-inactivated fetal bovine serum and antibiotics in a humidified 5% CO at 37C. Total RNA was prepared by a modification of the method of Karlinsey et al. Northern blot hybridization was performed by the method of Virca et al. EcoRI fragment of pVIM-GEM was used as probe for vimentin mRNA. DNA mobility shift assay was performed by the method of Lim et al. End labeled DNA probe (Upper strand, 5-CGCITGATGAGTCAGCCG-3) for AP-1 binding activity was mixed with nuclear extracts in a 20 pL reaction volume containing 300 mM KCI, 60 mM HEPES, pH 7.9, 25mM MgC1, 1mM EDTA, 1mM DTT, 60% glycerol, and 2 pg of poly[dI-dC]. RESULTS: The level of vimentin mRNA was decreased at 12 hours after retinoic acid treatment, and not detected at 48 hours. The level of vimentin mRNA was reduced in proportion to concentration of retinoic acid, Retinoic acid-reduced vimentin mRNA was no change in cells treated with cycloheximide. Retinoic acid-dependent decrease of vimentin mRNA was partially recovered by staurosporin pretreatment. In DNA mobility shift assay, AP-1 binding activity was reduced at 48 hr during retinoic acid-induced differentiation. CONCLUSION: These results suggest that the transcriptional repression of vimentin gene during retinoic acid-induced differentiation in HL-60 cells is correlated with reduction of DNA binding activity of AP-1.
Anti-Bacterial Agents ; Blotting, Northern ; Cell Differentiation ; Cell Line ; Cycloheximide ; Cytoplasm ; DNA ; Edetic Acid ; Electrophoretic Mobility Shift Assay ; Glycerol ; HEPES ; HL-60 Cells* ; Humans ; Hydrogen-Ion Concentration ; Repression, Psychology* ; RNA ; RNA, Messenger ; Transcription Factor AP-1 ; Tretinoin ; Vimentin*

We present a patient with multifocal symptomatic osseous chordomas having unusual growth patterns with review of the pertinent literature. The patient was 62-year-old male and had multiple osseous chordomas located in sacral, thoracic, and paraclival jugular foramen areas. There was no metastasis in other organs. All affected sites were osseous. The multicentric chordomas are extremely rare. This case could be considered as a chordoma involving multiple neuraxial bones. But, the possibility of multicentricity could also be thought. In such cases radical resection should be performed for each lesion at the initial diagnosis. If complete surgical resections are infeasible or impossible, preoperative or postoperative radiation therapy should be planned for the highest possibility of successful treatment.
Chordoma ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis

PURPOSE: Laparoscopic procedures for the treatment of patients with a rectal prolapse have gained increasing worldwide acceptance because they have lower recurrence and better functional outcome than perineal procedures. Nevertheless, ideal surgical methods are still not available. We propose a new surgical technique, laparoscopic vaginal suspension and rectopexy, for correcting a full-thickness rectal prolapse and/or middle-compartment prolapse. This study assessed the short-term outcomes for patients who underwent laparoscopic vaginal suspension and rectopexy. METHODS: Between April 2014 and April 2016, 69 female patients underwent laparoscopic vaginal suspension and rectopexy to correct a rectal prolapse. Demographics, medical histories, and surgical and follow-up details were collected from their medical records. In addition to the clinical outcome, we repeated defecation proctography and a questionnaire regarding functional results three months after surgery. RESULTS: No major morbidities or no mortalities occurred. The defecation proctography confirmed excellent anatomical result in all cases. Of 7 patients with combined middle-compartment prolapses, we observed good anatomical correction. During follow-up, full-thickness recurrence occurred in one patient. Preoperative fecal incontinence was improved significantly at 3 months (mean Wexner score: 12.35 vs. 7.71; mean FISI: 33.29 vs. 21.07; P < 0.001). Analysis of responses to the fecal incontinence quality of life (FIQOL) questionnaire showed overall improvement at 3 months compared to the preoperative baseline (mean pre- and postoperative FIQOL scores: 12.11 vs. 14.39; P < 0.004). CONCLUSION: Laparoscopic vaginal suspension and rectopexy is a new combined procedure for the treatment of patients with rectal prolapses. It has excellent functional outcomes and minimal morbidity and can correct and prevent middlecompartment prolapses.
Defecation ; Demography ; Fecal Incontinence ; Female ; Follow-Up Studies ; Humans ; Medical Records ; Mortality ; Prolapse ; Quality of Life ; Rectal Prolapse* ; Recurrence

BACKGROUND: Preoperative autologous donation is one of the most widely used methods of autotransfusion. However donation of predetermined units cannot often be achieved because of falling hematocrit with donations going on. We studied on the minimal effective dosage of recombinant human erythropoietin(rhEPO) used in preoperative autologous donation. METHODS: We conducted randomized trial of rhEPO in 45 adults for posterior spinal fusion procedures who had basal hematocrit less than 40 percent. The patients received either nothing(control group) or rhEPO(25 or 50 units/kg) intravenously twice a week for 21 days, during which time up to 3 units of blood was collected. Patients were excluded from donation when their hematocrit values were less than 33 percent. All patient received iron sulfate(256mg orally three times daily). RESULTS: The mean number of units collected per patient(mean+/-SD) was 3+/-0 for the 50-unit group(P<0.05 when compared with control group), 2.84+/-0.36 for the 25-unit group and 2.67+/-0.49 for the control group. The red cell volume donated by the patients who received rhEPO(347 ml, 325 ml) was greater than that donated by the control group(255 ml, P<0.05). The differences between hematocrits of the first and the third preoperative donations were significantly less in 50-unit group(1.50+/-2.05) and 25-unit group(1.51+/-1.85) than that of control group(3.73+/-1.66). Two patients of the 25-unit group and 5 patients of the control group required additional homologous blood postoperatively. And there were no significant differences in the pattern of postoperative changes of hemoglobin and hematocrit among each group. CONCLUSIONS: Fifty units per kilogram of body weight is considered appropriate to be the minimal effective dosage for preoperative autologous donation.
Adult ; Blood Transfusion, Autologous ; Body Weight ; Cell Size ; Erythropoietin* ; Hematocrit ; Humans* ; Iron ; Spinal Fusion