Adenoid cystic carcinoma (ACC) of the breast is an uncommon carcinoma accounting for less than 1% of the breast carcinoma. This type of carcinoma has a distinctive histology, such as cylindromatous, cribriform, glandlike space and solid pattern in the variable proportion. Prognosis is favorable with rare recurrence or metastasis and the guideline for therapy is not well established. We experienced a case of ACC of right breast in the 48 year-old woman. Cytologically, it showed numerous three-dimensional, well outlined cell clusters with central core of homogeneous, eosinophilic material. The mass was well demarcated, firm and measured 2.5 2.5 2 cm. Cut surface was yellowish white and granular with focal necrosis. Histologically, the tumor was composed of cylindromatous, adenoid and solid area with marked cellular atypia. Focal invasion was identified in the adipose tissue around the tumor. Histologic and nuclear grade was III by Kleer's grade. Nodal metastasis was not found.
Adenoids* ; Adipose Tissue ; Breast Neoplasms ; Breast* ; Carcinoma, Adenoid Cystic* ; Eosinophils ; Female ; Humans ; Middle Aged ; Necrosis ; Neoplasm Metastasis ; Prognosis ; Recurrence

A 52-year-old woman was admitted with a palpable mass on the abdominal wall. This tumor had developed at the same site of a previously resected dermatofibrosarcoma protuberans. The biopsy specimen from the recurrent tumor revealed malignant fibrous histiocytoma. Immunohistochemistry with anti-CD34 antibody revealed diffuse linear positivity on the tumor cells of dermatofibrosarcoma protuberans and negativity on malignant fibrous histiocytoma. Anti CD34 antibody was valuable for a differential diagnosis of these two lesions.
Abdominal Wall ; Biopsy ; Dermatofibrosarcoma* ; Diagnosis, Differential ; Female ; Histiocytoma, Malignant Fibrous* ; Humans ; Immunohistochemistry ; Middle Aged

BACKGROUND: Before the introduction of the antinuclear antibody test (ANA), the lupus erythematosus (LE) cell test was a useful diagnostic test for systemic lupus erythematosus(SLE) But, the ANA test has replaced the LE cell test in virtually all laboratories as the current routine test for SLE. However, because the LE cell test is still performed in some laboratories, the authors compared the LE cell test with the ANA test to reevaluate the LE cell test. METHODS: A total of 522 cases were evaluated from Aug. 1990 to Aug. 1994. In these cases, the LE cell test and the ANA test were performed simultaneously, and the results were compared. The authors defined the 'True LE Phenomenon' as only when the LE cell test results agreed with the anti-histone antibody pattern of the ANA test. RESULTS: Of the total 522 cases, 56 cases(10.7%) were SLE. The LE cell test was positive in 22 cases(39.3%) and the ANA test in 56 cases(100%). The LE cell test produced 6(27%) false positive cases and 3 (8.8%) false negative cases. Therefore, the sensitivity of the LE cell test that was verified by the ANA test was only 28.6%. On the other hand, the sensitivity of the ANA test was 100%. In 2 cases, the LE cell results were different in repetitive tests although the ANA results were the same. In 2 other cases, it was impossible to interprete the results of the LE cell test because of severe leukopenia. CONCLUSIONS: The authors concluded that the LE cell test showed markedly low sensitivity and a high false positive and false negative rates for SLE, and that the LE cell test was difficult to perform and interpret accurately due to numerous interfering factors. Therefore, for accurate diagnosis of SLE, the LE cell test must be replaced by more definitive and quantitative immunologic tests in all laboratories such as the ANA test.
Antibodies, Antinuclear ; Diagnosis ; Diagnostic Tests, Routine ; Hand ; Immunologic Tests ; Leukopenia ; Neutrophils*

BACKGROUND: Before the introduction of the antinuclear antibody test (ANA), the lupus erythematosus (LE) cell test was a useful diagnostic test for systemic lupus erythematosus(SLE) But, the ANA test has replaced the LE cell test in virtually all laboratories as the current routine test for SLE. However, because the LE cell test is still performed in some laboratories, the authors compared the LE cell test with the ANA test to reevaluate the LE cell test. METHODS: A total of 522 cases were evaluated from Aug. 1990 to Aug. 1994. In these cases, the LE cell test and the ANA test were performed simultaneously, and the results were compared. The authors defined the 'True LE Phenomenon' as only when the LE cell test results agreed with the anti-histone antibody pattern of the ANA test. RESULTS: Of the total 522 cases, 56 cases(10.7%) were SLE. The LE cell test was positive in 22 cases(39.3%) and the ANA test in 56 cases(100%). The LE cell test produced 6(27%) false positive cases and 3 (8.8%) false negative cases. Therefore, the sensitivity of the LE cell test that was verified by the ANA test was only 28.6%. On the other hand, the sensitivity of the ANA test was 100%. In 2 cases, the LE cell results were different in repetitive tests although the ANA results were the same. In 2 other cases, it was impossible to interprete the results of the LE cell test because of severe leukopenia. CONCLUSIONS: The authors concluded that the LE cell test showed markedly low sensitivity and a high false positive and false negative rates for SLE, and that the LE cell test was difficult to perform and interpret accurately due to numerous interfering factors. Therefore, for accurate diagnosis of SLE, the LE cell test must be replaced by more definitive and quantitative immunologic tests in all laboratories such as the ANA test.
Antibodies, Antinuclear ; Diagnosis ; Diagnostic Tests, Routine ; Hand ; Immunologic Tests ; Leukopenia ; Neutrophils*

The occurrence of sqamous cell carcinoma arising from epidermal cyst is unusual. A 54-year-old man with soft tissue mass on the back for 25 years presented an infiltrating squamous cell carcinoma within the wall of epidermal cyst. All tissue excised deserved to be examined to be axamined carefully in longterm epidermal cyst.
Male ; Humans ; Cysts

The expression of the nuclear phosphoprotein p53, a product of tumor suppressor gene, has been noted in a number of human tumors as a tumor suppressor. nm23 is a gene associated with low tumor metastatic potential and has been proposed to be a metastasis suppressor gene. To assess the role of p53 and nm23 expression in colorectal tumorigenesis and the association with clinicopathological parameters, an immunohistochemical study for mutant p53 and nm23 was done using mouse monoclonal antibodies in 43 colorectal carcinomas, 55 tubular adenomas and corresponding normal mucosa. In the tubular adenomas, p53 expression was significantly correlated with the degree of atypism(p<0.05) but not with other variables as well as with nm23. In the colorectal carcinoma, there were evidence of some correlation between metastasis, laterality and p53; laterality, depth of invasion and nm23 expression, but without statistical significance. Other clinicopathologic features were not significantly correlated. In the aspect of 'adenoma-carcinoma sequence', normal mucosa was totally negative for both p53 and nm23, and they were increasingly expressed through tubular adenoma to carcinoma with statistical significance(p<0.05). Therefore, it is suggested that both p53 and nm23 expressions occur in and around the time of transition to carcinoma from adenoma but are not significantly associated with the infiltrative behavior and metastasis.
Adenoma* ; Animals ; Antibodies, Monoclonal ; Carcinogenesis ; Colorectal Neoplasms ; Genes, Tumor Suppressor ; Genes, vif ; Humans ; Mice ; Mucous Membrane ; Neoplasm Metastasis

To define the basic sequential events of the healing process in normal fracture and evaluate the role of growth regulatory molecules and extracellular matrix components, the expression of transforming growth factor β(TGF-β), platelet-derived growth factor(PDGF), type I and II collagen, and chemistry during the healing process of an experimental fracture of tibia in 41 adult rats for 7 weeks using ABC methods. The phases of inflammation, reparation, and remodeling followed each other in sequence. The inflammatory phase was characterized by hemorrhage, edema, and infiltration of inflammatory cells on the first day. During the reparative phase, the undifferentiated mesenchyme undergoes rapid chondrogenesis, followed by endochondral ossification and supplemented by appositional bone formation. At day 3, the expression of TGF-β and PDGF was noted in the undifferentiated mesenchymal cells and from day 5, these two growth factors were detected in the osteoblasts and extracellular matrix in areas of endochondral ossification and newly formed periosteal bone. From day 3, the expression of type I collagen and osteonectin was noted in the osteoblasts and extracellular matrix in both endochondral ossification and appositional bone growth as a marker of ossification. From day 3, type III collagen was mainly expressed in the plump mesenchymal cells showing chondroid differentiation and chondroid matrix as a marker of cartilaginous reparative phase. From day 14, these growth factors and extracellular matrix components were decreased in staining intensity and at the 5th week, the histology and immunostaining pattern were similar to the mature bone.
Adult ; Animals ; Bone Development ; Chemistry ; Chondrogenesis ; Collagen Type I ; Collagen Type III ; Collagen ; Edema ; Extracellular Matrix ; Fracture Healing ; Hemorrhage ; Humans ; Inflammation ; Intercellular Signaling Peptides and Proteins ; Mesoderm ; Osteoblasts ; Osteogenesis ; Osteonectin ; Rats ; Tibia ; Transforming Growth Factors

Malignant tumors of the breast with stromal multinucleated giant cells are rare entity of uncertain clinical significance. There have been few reports on the fine needle aspiration cytologic(FNAC) findings about these rare tumors. We report a FNAC case of invasive mammary carcinoma with osteoclast-like giant cells not only for its rare occurrence but in particular for its distinctive cytologic picture on aspirated material. The patient was a 40-year-old woman who presented with a right breast mass for one month. Mammography showed a well-demarcated rounded mass density without calcification. The aspirates of FNAC were highly cellular and two main cell types were seen; malignant epithelial cells and osteoclast-like multinucleated giant cells. The carcinoma cells occurred singly or arranged in loose clusters with ill-defined cytoplasm, oval nuclei, coarse chromatin and small but distinct nucleoli. The multinucleated giant cells showed variable number of nuclei with prominent nucleoli and abundant dense oxyphilic cytoplasm. The immunocytochemical studies suggested that osteoclast-like giant cells were not of epithelial origin, but rather of histiocytic origin.
Adult ; Biopsy, Fine-Needle* ; Breast ; Carcinoma, Ductal* ; Chromatin ; Cytoplasm ; Epithelial Cells ; Female ; Giant Cells* ; Humans ; Mammography

BACKGROUND: Health illiteracy is a problem often unrecognized by health care providers. It influences medical costs and the health status of adults. The purposes of this study were to determine the level of health literacy in community-dwelling adults and to identify the factors influencing it. METHODS: A cross-sectional survey was conducted in Seoul, Gyeonggi and Chungcheong province. A total of 420 adults aged 18 or older were interviewed by trained nursing students between November 1 to December 30, 2011. Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Data were analyzed using the PASW 18.0 program. RESULTS: The mean score of health literacy was 50.64+/-19.18. In the multiple linear regression analysis, health literacy was significantly associated with education (beta=0.17, P=0.001), alcohol use (beta=-0.12, P=0.010), and perceived health status (beta=0.11, P=0.029). These factors accounted for about 7% of health literacy. CONCLUSIONS: Health literacy is a very important public health issue. Our findings showed that educational level, alcohol use and perceived health status should be considered when assessing this issue in patients. Furthermore, the development of a standardized Korean assessment tool for health literacy and specified interventions for enhancing health literacy are needed to improve health outcomes.
Adult* ; Cross-Sectional Studies ; Education ; Gyeonggi-do ; Health Literacy* ; Health Personnel ; Health Status ; Humans ; Linear Models ; Literacy ; Primary Prevention ; Public Health ; Seoul ; Students, Nursing

Neuroacanthocytosis is a rare hereditary disorder characterized by various neurological symptoms and the presence of abnormal red blood cell called acanthocytosis. Degeneration of striatum, which accounts for characteristic motor and psychiatric symptoms, mainly attributes to the pathology of neuroacanthocytosis. We experienced a case of chorea-acanthocytosis. He was a 50 year-old-man who presented with orofacial dyskinesia, dysarthria, uncontrolled lip biting, generalized choreic movements and sensorymotor polyneuropathy. He was also suffered from obsessive eating behavior, disinhibition, impulsivity and sleep disturbance. After antipsychotic medication, his psychiatric problems were improved. Clinicians must consider psychiatric managements of progressive neurological disorder for patients' quality of life and reducing their caregiver's burden.
Abetalipoproteinemia ; Antipsychotic Agents ; Bites and Stings ; Chorea ; Dysarthria ; Erythrocytes ; Feeding Behavior ; Humans ; Lip ; Movement Disorders ; Nervous System Diseases ; Neuroacanthocytosis ; Polyneuropathies ; Quality of Life