Wegener's granulomatosis is a systemic necrotizing vasculitis of unknown cause. The disease is characterized by the involvement of the upper airway, the lung, and the kidney. Skin lesions are frequent and the most common lesion is purpura distributed on the limbs and trunk. A 34-year-old female showed recurrent purpuric macules on the both lower extremities and buttocks. The patient. showed nasal septal perforation with saddle nose deformity and C-ANCA positivity. Histopathologic findings of purpuric lesion revealed the features of necrotizing vasculitis. The histologic specimen from the nasal cavity showed chronic inflammation with granuloma formation and kidney showed focal necrotizing glomerulonephritis. Therefore, we treated the patient with prednisolone and cyclophosphamide having diagnosed Wegener's granulomatosis.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Buttocks ; Congenital Abnormalities ; Cyclophosphamide ; Extremities ; Female ; Glomerulonephritis ; Granuloma ; Humans ; Inflammation ; Kidney ; Lower Extremity ; Lung ; Nasal Cavity ; Nasal Septal Perforation ; Nose ; Prednisolone ; Purpura ; Skin ; Vasculitis ; Wegener Granulomatosis

A case of pulmonary alveolar proteinosis is reported. Most of the alveolar spaces were filled with amorphous deep eosinohilic material which revealed strong positive reaction to periodic acid-Schiff staining. Electron microscopic observation of this material showed numerous lamellar bodies in the alveolar spaces and cytoplasms of alveolar macrophages. A part of them were concentric multilamellated type A lamellar bodies and the other were finger printlike type B bodies. Combined type A and type B lamellar bodies were rarely present. From the above features it is suggested that both type A and B lamellar bodies could be transformed one another and those lamellar bodies may be originated from pulmonary surfactant.

Perigraft seroma is uncommon complication of polytetrafluoroethylene(PTFE) grafts applied as an arteriovenous shunt for hemodialysis. It is a collection of clear, sterile fluid confined to nonsecretory fibrous pseudomembrane, most commonly localized around the middle and distal portion of graft. The possible etiologic factors of perigraft seroma include poor graft incorporation, mechanical graft damage caused by alcohol and povidone-iodine, intraoperative streching of the graft, variations in quality control at the time of manufacture and contributing factors such as anemia and coagulopathy in uremia. The best strategy for management of perigraft seroma is not clear. spiration or drainage alone is not effective, and some authors advocate graft removal. We report a case of perigraft seroma around arterial end of PTFE graft along with a brief review of the literatures.
Anemia ; Drainage ; Humans ; Polytetrafluoroethylene ; Povidone-Iodine ; Quality Control ; Renal Dialysis* ; Seroma* ; Transplants ; Uremia

No abstract available.
Chorion* ; Chorionic Villi Sampling* ; Chorionic Villi* ; Female ; Pregnancy

Localized or solitary fibrous tumor (SFT) of the pleura has been classified as a type of mesothelioma, arising from the submesothelial connective tissue cells. The preoperative diagnosis of the tumor at the cytologic or histologic level is very important for the proper handling of the lesion. This preoperative diagnosis is now possible by means of the advance in the transthoracic fine needle aspiration biopsy (FNA) techniques and in the very experience of the cytopathologists. We describe FNA cytologic feature of two cases of SFT arising from the pleura. Cytologic, histologic, immunohistochemical, and electron microscopic characteristics of pleural SFT are discussed. The tumor cells of SFT are spindle or oval in shape with a variable amount of cytoplasm. They are arranged in irregular trabeculae intimately ass- ociated with capillaries. A unique cytologic feature observed in this tumor is that thick, eosinophilic, amorphous collagen bundles are scattered between tumor cells
Biopsy ; Biopsy, Fine-Needle ; Capillaries ; Child* ; Collagen ; Connective Tissue Cells ; Cytoplasm ; Diagnosis ; Eosinophils ; Hematuria* ; Humans ; Mesothelioma ; Pleura ; Rhabdomyosarcoma ; Solitary Fibrous Tumors

No abstract available.
Pressure Ulcer*

No abstract available.

This experimental study was conducted to evaluate the effect of indomethacin and methylprednisolone on PAN-induced nephrosis in rats. Sprague-Dawley rats weighing 150~200gm were used and divided into controls, group I (PAN intraperitoneally), group II(PAN intraperitoneally, followed by indomethacin peritoneally for 12 days), group III (PAN intraperitoneally, followed by methylprednisolone peritoneally for 12 days) and group IV (PAN intraperitoneally, followed by cyclosporin subcutaneously for 12 days). Twenty four-hour urinary protein excretion was measured on day 0, 5, 10 and 17. On the 17th day, rats were sacrificed for the determination of total serum protein, albumin and cholesterol levels. Foot process widths of glomerular epithelial cells were measured, and anionic sites of lamina rara externa were determined by using PEI as cationic probes. The following results were obtained. Twenty four-hour urinary protein excretion (mg/day) of group I was significantly increased to 455.7+/-188.8 on the 5th day compared to 15.2+/-3.7 on day 0 (p<0.01), and increased gradulally to 525.6+/-203.5 on the 10th day, then decreased to 280.6+/-25.2 on the 17th day. In group III, 24 hr urinary protein excretion on 17 th day (180.7+/-64.5) was significantly lower than that of group I (280.6+/-25.2). Total serum protein of group III was significantly lower than that of group I, and serum albumin and cholesterol did not show any significant difference among Group I, II, III and IV. Foot process widths (nm) of glomerular epithelial cells in group I, II, III and IV were 409.5+/-15.2, 387.8+/-49.2, 279.9+/-36.9 and 398.3+/-38.3, respectively. And the value of group of group III was significantly lower than that of group I (p<0.01). The number of anionic sites per 1micrometer length of glomerular basement membrane in Group I, II, III and IV were 10.3+/-1.3, 10.1+/-1.6, 12.5+/-1.5and 10.2+/-1.5, respectively. And the value of group III was significantly lower than that of group I (P<0.01). In conclusion, cyclosporin and indomethacin did not show any significant effect on PAN nephrosis in rat. However, methylprednisolone reduced the urinary protein excretion and showed significant recovery of foot process widths and number of anionic sites of glomerular basement membrane.
Animals ; Cholesterol ; Cyclosporine* ; Epithelial Cells ; Foot ; Glomerular Basement Membrane ; Indomethacin* ; Methylprednisolone* ; Nephrosis* ; Nephrotic Syndrome ; Rats* ; Rats, Sprague-Dawley ; Serum Albumin

A statistical analysis of the diagnostic value for 244 aspiration biopsy cytology(ABC) among a total 1,043 cases from various sites was performed. ABC, using diagnostic terminology similar to that of a surgical pathology reports, was compared to the final tissue diagnosis. For the entire series, a sensitivity of 91.8%, a specificity of 99.3%, a positive predictive value of 98.9%, a negative predictive value of 94.8%, and an efficacy of the test of 96.3% were shown. There were 8 false negative and 1 false positive diagnosis. The diagnostic accuracy was 89.8%. Those results indicate that the ABC is a considerably highly accurate procedure that should be routinely employed.
Biopsy, Needle ; Child* ; Diagnosis ; Glomerulonephritis, IGA* ; Humans ; Immunoglobulin A* ; Intranuclear Inclusion Bodies ; Meningioma ; Pathology, Surgical ; Sensitivity and Specificity

BACKGROUND: The external jugular vein (EJV) is a useful intravenous (IV) cannulation site for anesthesiologists, although it has a relatively high failure rate. Unlike other central veins, visualization of the EJV is important during IV cannulation, and the Valsalva maneuver distends the jugular venous system. However, the relationship between the maneuver and EJV visibility remains unknown. This study compared EJV visibility before and after the Valsalva maneuver. METHODS: This was a prospective observational study that included 200 participants. After the induction of anesthesia, EJV visibility grade, depth from the skin to the EJV superficial surface (EJV depth), and EJV cross-sectional area (CSA) before the Valsalva maneuver were measured. The same parameters were measured after the Valsalva maneuver was performed. The EJV visibility grade was defined as grade A: good appearance and good palpation, grade B: poor appearance and good palpation, and grade C: poor appearance and poor palpation. RESULTS: Patient body mass index and EJV depth affected the EJV visibility grade before the Valsalva maneuver (p < 0.05), although EJV CSA did not. The Valsalva maneuver distended EJV CSA and reduced EJV depth, although these changes were not correlated with EJV visibility grade. With regard to EJV visibility, 34.0% of grade B cases and 20.0% of grade C cases were improved by the Valsalva maneuver. CONCLUSIONS: Although the Valsalva maneuver improved EJV CSA and EJV depth, it did not greatly affect EJV visibility grade.
Anesthesia ; Body Mass Index ; Catheterization ; Humans ; Jugular Veins* ; Observational Study ; Palpation ; Prospective Studies ; Skin ; Ultrasonography ; Valsalva Maneuver* ; Veins