Epithelial-myoepithelial carcinoma of intercalated duct(origin) is a recently described tumor characterized by its typical biphasic pattern of central duct like cell and peripheral clear cell. We described a case of epithelial-myoepithelial carcinoma in a 10-year-old boy. Microscopically, the tumor showed typical biphasic pattern, diffuse proliferation of clear cells and linining epithelial cells of tubular structures. Immunohistochemically, the clear cell showed positive reaction to S-100 protein, and the epithelial cells expressed cytokeratin indicating myoepithelial and epithelial differentiation respectively. Biphasic differentiation of the tumor cells could be also proved by electronmicroscopic study.

No abstract available.
Arthritis, Rheumatoid* ; Humans ; Neuroma*

Pancreatoblastoma has been described in children and characterized by unique histologic features and excellent clinical course. Ultrastructural and immunohistochemical studies of pancreatoblastoma reveal either exocrine alone or both endocrine and exocrine differentiation. We present two cases of pancreatoblastoma in children in which immunohistochemical and ultrastructural examination failed to demonstrate features of either enzyme or hormone production and which became worse in clinical course. We assume that pancreatoblastomas are tumors which differentiate more toward acinar or ductal elements than toward islet cell.
Carcinoma/*pathology/ultrastructure ; Child, Preschool ; Female ; Humans ; Pancreatic Neoplasms/*pathology/ultrastructure

No abstract available.
Child* ; Glomerulonephritis, IGA ; Hematuria* ; Humans ; Nephritis* ; Purpura, Schoenlein-Henoch*

PURPOSE: The present study was performed to determine the optimum conditions(RPM, load, sharpness of drill) for drilling human cortical bone with standard drill, and to evaluate the histological changes occuring in bone after drilling. MATERIALS AND METHODS: in experiment I, we measured temperature elevations and the durations of temperature elevation in cadaveric femoral cortices at specific distances from the drill hole wall while drilling. The effects of drilling force, speed and new versus worn drill on the termperature were determined. In experiment II, we also measured temperature elevations in the same manner in porcine femoral cortices and evaluated the histological changes occuring in bone after drilling. RESULTS: In experiment I, the most significant temperature elevation(68.4degrees C ) was found when worn drill was used. The lower drilling force and faster speed resulted in 55.1degrees C and 45.8degrees C temperature elevation, respectively. However, drill diameter was not a significant factor for temperature elevation. In experiment II, greater heat production was measured with worn drill, at lower drilling forces, at faster drill speed. The acute histologic reactions in bone were hyperemia, degeneration of osteocytes, change in bone stainability, tears, and fragmentation of the bone edges around the drill holes. The observed histological changes were proportional to the amount of trauma produced, that is, the greater the degree of thermal irritation, the greater the degree of histologic activity. CONCLUSION: In cortical drilling, greater heat production was measured with worn drill, at lower drilling forces, at faster drill speed and the greater the degree of thermal irritation, the greater the degree of histologic activity. A further study of the reaction of bone to drilling at longer intervals of time at different conditions may possibly show whether aseptic thermal necrosis could be prevented.
Cadaver ; Hot Temperature* ; Humans ; Hyperemia ; Necrosis* ; Osteocytes ; Thermogenesis*

No abstract available.
Calcium Pyrophosphate* ; Calcium* ; Knee Joint* ; Knee*

BACKGROUND: Angiocentric T-cell lymphomas are rare T-cell malignancies which involve extranodal sites, such as the skin, nasal cavity, soft tissue and gastrointestinal tract. They have been reported with significant frequency in Asia. OBJECTIVES: The main objective of this study is to characterize the clinical, pathological, and immunohistochemical featnres of cutaneous angiocentric T-cell lymphoma. Another objective is to search for the Epstein-Barr virus (EBV) in the tissues of cutaneous angiocentiric T cell lymphoma. METHODS: Clinical records, laboratory data, and histopathologic sections of 12 patients with cutaneous angiocentric T-cell lymphoma were reviewed. Paraffin tumor tissues were immunophenotyped. In situ hybridizaion studies were performed to detect the EBV genomes. RESULTS: The ages of the 12 patients ranged from 34 to 64 years(mean 45.8 years). The cutaneous lesions were nodules or plaqes, and were with ulcerated or had intact skin. Eight patients had evidence of extracutaneous involvement, usually involving lymph nodes, liver, and spleen. Eleven patients showed the abnormal laboratory findings including anemia, leukopenia, and elevated level of LDH. The disease pursued an aggressive course and was not uncommonly resistant to treatment. Histologically, the lymphomatous infiltrate occurred predominantly in the subcutaneous layer with involvement of the dermis. The pattern was mainly perivascular and periadnexal. A prominent feature was invasion of small or medium vesselsby lymphoma cells. The infiltrating lymphrcytes expressed CD45RO in all cases; variable expression of CD3 and CD56 was detected in piaffin sections. Among the 11 cases where in situ hybridization was performed, EBV genome could be detected in 9 cases. CONCLUSION: Angiocentric T-cell lymphoma of the skin is an aggressive lymphoma distinct from classic cutaneous T-cell lymphoma. However, further studies are needed to regard them as a homogeneous entity of T-cell lymphoma involving the skin.
Anemia ; Asia ; Dermis ; Gastrointestinal Tract ; Genome ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Leukopenia ; Liver ; Lymph Nodes ; Lymphoma* ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Nasal Cavity ; Paraffin ; Skin* ; Spleen ; T-Lymphocytes ; Ulcer

BACKGROUND: This study evaluated the benefits and safety of a multimodal pain control protocol, which included a periarticular injection of local anesthetics, in patients undergoing total hip arthroplasty. METHODS: Between March 2006 and March 2007, 60 patients undergoing unilateral total hip arthroplasty were randomized to undergo either a multimodal pain control protocol or a conventional pain control protocol. The following parameters were compared: the preoperative and postoperative visual analogue scales (VAS), hospital stay, operative time, postoperative rehabilitation, additional painkiller consumption, and complication rates. RESULTS: There was no difference between the groups in terms of diagnosis, age, gender, and BMI. Although both groups had similar VAS scores in the preoperative period and on the fifth postoperative day, there was a significant difference between the groups over the four-day period after surgery. There were no differences in the hospital stay, operative time, additional painkiller consumption, or complication rate between the groups. The average time for comfortable crutch ambulation was 2.8 days in the multimodal pain control protocol group and 5.3 days in the control group. CONCLUSIONS: The multimodal pain control protocol can significantly reduce the level of postoperative pain and improve patients' satisfaction, with no apparent risks, after total hip arthroplasty.
Adult ; Aged ; Amides/administration & dosage ; Analgesia/*methods ; *Arthroplasty, Replacement, Hip ; Clinical Protocols ; Female ; Humans ; Injections, Intra-Articular ; Length of Stay ; Male ; Methylprednisolone/administration & dosage ; Middle Aged ; Morphine/administration & dosage ; Narcotics/administration & dosage ; Pain/prevention & control ; Pain Measurement ; Pain, Postoperative/prevention & control

The high cardiac output state and an increased incidence of atrial fibrillation are well-known cardiovascular complications of Graves' disease, whereas the valvular complications are less well recognized. With 2D color Doppler echocardiography, the cardiac and valvular function of 39 patients with Graves' disease were evaluated and our data were compared with previous Kage's study. The incidences of mitral regurgitation (MR) and tricuspid regurgitation (TR) in patients with Graves' disease were 54% and 51%, respectively. There was no correlation between the incidence of MR and ventricular dilatation. In patients with congestive heart failure (CHF), the incidences of severe TR and atrial fibrillation were significantly higher than in patients without CHF. The incidences of TR and MR in patients with Graves' disease were not different by thyroid function status (hyperthyroid vs. euthyroid). We suggest that the examination for TR and MR in patients with Graves' disease is important not only their high prevalence but also their clinical significance as a risk factor for CHF.
Atrial Fibrillation ; Cardiac Output, High ; Dilatation ; Echocardiography, Doppler, Color ; Graves Disease* ; Heart Failure ; Heart Valve Diseases ; Humans ; Incidence ; Mitral Valve Insufficiency ; Prevalence ; Risk Factors ; Thyroid Gland ; Tricuspid Valve Insufficiency

Given the CYP3A4 and CYP3A5's impact on the efficacy of drugs, the genetic backgrounds of individuals and populations are regarded as an important factor to be considered in the prescription of personalized medicine. However, genetic studies with Korean population are relatively scarce compared to those with other populations. In this study, we aimed to identify CYP3A4/5 polymorphisms and compare the genotype distributions among five ethnicities. To identify CYP3A4/5 SNPs, we first performed direct sequencing with 288 DNA samples which consisted of 96 Koreans, 48 European-Americans, 48 African-Americans, 48 Han Chinese, and 48 Japanese. The direct sequencing identified 15 novel SNPs, as well as 42 known polymorphisms. We defined the genotype distributions, and compared the allele frequencies among five ethnicities. The results showed that minor allele frequencies of Korean population were similar with those of the Japanese and Han Chinese populations, whereas there were distinct differences from European-Americans or African-Americans. Among the pharmacogenetic markers, frequencies of CYP3A4*1B (rs2740574) and CYP3A5*3C (rs776742) in Asian groups were different from those in other populations. In addition, minor allele frequency of CYP3A4*18 (rs28371759) was the highest in Korean population. Additional in silico analysis predicted that two novel non-synonymous SNPs in CYP3A5 (+27256C>T, P389S and +31546T>G, I488S) could alter protein structure. The frequency distributions of the identified polymorphisms in the present study may contribute to the expansion of pharmacogenetic knowledge.
Asian Continental Ancestry Group ; Computer Simulation ; Cytochrome P-450 Enzyme System ; DNA ; Gene Frequency ; Genotype ; Humans ; Precision Medicine ; Mass Screening* ; Pharmacogenetics ; Polymorphism, Genetic* ; Polymorphism, Single Nucleotide ; Prescriptions