Fine needle aspiration biopsy cytology (FNA) for diagnosis of a variety of breast tum- ors has been proven to be a simple, safe, and cost saving diagnostic methodology with high accuracy. Cytologic specimens from 1,029 fine needle aspirations of the breast during last 3-year period were reviewed and subsequent biopsies from 107 breast lesions were reevaluated for cytohistological correlation. FNA had a sensitivity of 81.6% and a specificity of 98.3%. One out of 107 cases bio- psied revealed a false positive result (0.9%) and the case was due to misinterpretation of apocrine metaplastic cells in necrotic backgound as malignant cells. A false negative rate was 8.4% (9 of 107 cases biopsied). Six of 9 false negative cases were resulted from insufficient aspirates for diagnosis, and remaining three of 9 false negative cases revealed extensive necrosis with no or scanty viable cells on smears. The results indicate that for reducing false positive and false negative rates of FNA, an experienced cytopathologist and a proficient aspirator are of great importance.
Adenoma, Pleomorphic ; Aspirations (Psychology) ; Biopsy ; Biopsy, Fine-Needle ; Breast ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Child* ; Cost Savings ; Diagnosis ; Humans ; Necrosis ; Needles ; Sensitivity and Specificity ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux*

The ultrasound-guided fine needle aspirations were performed in order to diagnose a suspected neoplastic orinfectious diseases in 52 patients with focal liver disease. Of these, neoplastic lesions were suspected in 31patients and infectious lesions in 21 patients ultrasonically and/or clinically. The overall accuracy for bothsuspected malignant and infectious disease was 79%(41/52). The primary indication for fine needle aspiration wasto document the presense of malignancy and to avoid a diagnostic laparotomy, and to drain hepatic abscesses.Consequently we were convinced that the ultasound
Aspirations (Psychology) ; Biopsy ; Biopsy, Fine-Needle ; Communicable Diseases ; Diagnosis ; Humans ; Laparotomy ; Liver Diseases ; Liver ; Methods ; Needles ; Ultrasonography

PURPOSE: Present study has been undertaken to determine the distribution of various renal diseases causing asymptomatic hematuria in children and to evaluate the benefit of doing renal biopsy in these children. METHODS: Study population consisted of 146 children with asymptomatic primary hematuria who had been admitted to the pediatric department of Kyungpook National University Hospital for the past 4 years from 1999 to 2002. In 122 out of 146 cases, renal biopsy was performed percutaneously and in 24 out of 146 cases, diagnosed as idiopathic hypercalciuria, oral calcium loading test was performed. RESULTS: The age(mean+/-SD) at onset or discovery of hematuria of the 146 children included in this study was 8.0+/-3.2 years and the proportion of boys and girls was 54.8% and 45.2%, respectively. In 76 out of 146 cases(52%), asymptomatic hematuria was first diagnosed by school urinalysis screening. The proportion of histopathologic findings based on 122 biopsies was as follows : Thin Glomerular Basement Membrane(TGBM) 73 cases(50%); IgA nephropathy 20 cases(14%); Alport syndrome 6 cases(4%); Membranous Glomerulonephropathy(MGN) 4 cases(3%); Membranoproliferative Glomerulonephritis(MPGN) 2 cases(1%); IgA nephropathy with TGBM 3 cases(2%); "normal" glomeruli 14 cases(10%). Twenty four cases (16%) were diagnosed as idiopathic hypercalciuria. During follow-up periods, 15% of 146 cases became hematuria-free and renal function did not deteriorate in any cases. CONCLUSION: Unless hematuric children manifest poor prognostic indicators for renal survival, we would recommend long term regular follow-up prior to a renal biopsy.
Biopsy ; Calcium ; Child* ; Female ; Follow-Up Studies ; Glomerulonephritis, IGA ; Gyeongsangbuk-do ; Hematuria* ; Humans ; Hypercalciuria ; Mass Screening ; Nephritis, Hereditary ; Urinalysis

BACKGROUND: Recently, the molecular pathologic investigation for clonality in lymphomas has been introduced and has gained a role in the diagnosis of lymphomas. In fact, the clonality test using TCRGR phenomenon has been done by Southern blot analysis (SBA) and polymerase chain reaction (PCR) for molecular pathologic diagnosis of T cell lymphomas. However, it is difficult to perform SBA with paraffin embedded specimens or with samples of small skin biopsies. OBJECTIVE: We investigated the efficacy of PCR amplification of TCR gene in paraffin em-bedded cutaneous T cell lymphomas. METHODS: Iii this study, the clonality was assessed by polymerase chain reaction (PCR) analysis of T cell receptor gamma (TCR) gene from the DNA extracts obtained from paraffin em-bedded tissues (PET) of malignant T cells, B cell lymphomas, and benign cutaneous T cell proliferative disorders. Heteroduple-x-analyses were also performed to rule out the false positives. RESULTS: Among the total of 62 cases analyzed, monoclonality was observed in 4 out of 10 mycosis fungoides, 7 out of 9 cutaneous T cell lymphomas excluding mycosis fungoides, 1 out of 3 angiocentric lymphomas, 2 out of 2 lymphomatosis papulosis, 1 out of 7 large plaque parapsoriasis, and 1 out of 2 T cell lymphomas in other organs. No monoclonality was observed in 9 inflammatory cutaneous diseases, 5 small plaque parapsoriasis, 4 cutaneous B cell lymphomas, and 11 B cell lymphomas in lymph nodes. CONCLUSION: The results suggest that the PCR method and heteroduplex analysis used in this study were not only practical but also efficacious for the diagnosis of cutaneous T cell lymphomas using tissues embedded in paraffins.
Biopsy ; Blotting, Southern ; Diagnosis ; DNA ; Gene Rearrangement* ; Genes, T-Cell Receptor ; Heteroduplex Analysis* ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Cutaneous ; Mycosis Fungoides ; Paraffin ; Parapsoriasis ; Polymerase Chain Reaction* ; Receptors, Antigen, T-Cell* ; Skin ; T-Lymphocytes

PURPOSE: Orthostatic proteinuria accounts for the majority of cases of proteinuria that present in childhood or adolescent. This study was conducted to see the prevalence of Nutcracker syndrome (NCS) in children with orthostatic proteinuria using venography. METHODS: Study patients consisted of 23 children with orthostatic proteinuria. The diagnosis of NCS was made by high pressure gradients (> or =4 mmHg) between left renal vein (LRV) and inferior vena cava (IVC) in left renal venography and pressure tracing. RESULTS: Of 23 study patients, the venography showed 12 cases (52%) of typical NCS. Their mean age was 11.5 years (9-14 years). Female predominance (Male:Female=2:10) was noted. In NCS group (n=12), venous pressures of IVC and LRV were 6.50+/-3.34 and 13.21+/-3.53 mmHg, respectively. This pressure gradient between two veins was 6.71+/-2.54 mmHg, which is significantly higher than that of non-NCS group (n=11), 2.17+/-0.94 mmHg (p < 0.05). No positive correlation was observed between urinary protein during 24 hour and pressure gradient (r=0.152, p=0.636). CONCLUSION: NCS may be an important cause of orthostatic proteinuria in children. The prevalence of NCS shown in this study was very similar to that in a doppler sonographic observation published previously. A larger-scale study is necessary to confirm the prevalence.
Adolescent ; Child ; Female ; Humans ; Phlebography ; Prevalence ; Proteinuria ; Renal Veins ; Veins ; Vena Cava, Inferior ; Venous Pressure

OBJECTS: Depressive symptoms are common in the elderly medical inpatients. But depressive disorders are considerably underdiagnosed and undertreated. Especially in major depressive disorder, patients show cognitive impairments and do not respond adequately to medical treatment. The goals of this study were to examine what are the patterns of depressive symptoms of major depressive disorders which differentiate from minor depressive disorders in the elderly medical inpatients. METHODS: A 4-month prospective study of 312 patients (65 years and older) was conducted in a general hospital. Depression was screened with Hamilton Depression Rating Scale and cognitive function was screened with Mini-Mental State Examination-K. The subjects were diagnosed according to DSM-IV for depression. And according to DSM-IV diagnosis, HDRS and MMSE-K subscales were analysed. RESULTS: In the 228 patients who were investigated, 16 (7%) patients were major depressive disorder, 53 (23%) were minor depressive disorder. Females were more depressed than males but there was no statistical significance. While the patients of major depressive disorder complained of depression and anxiety, the control subjects complained of loss of body weight, somatic symptoms and somatic anxiety, and the minor depressive disorders shows mixed symptoms of the two. The complaining frequency of the somatic symptoms and somatic anxiety were similar among the three groups. Significant differences were found among the three groups in terms of HDRS total scores. Among the three groups in terms of HDRS subscale scores all subscale scores except for the genital symptoms and body weight were significantly high in depressive disorders. Initial insomnia (p<0.01), middle insomnia (p<0.05), GI symptoms (p<0.01) and somatic symptomgeneral (p<0.05) were significantly different between the control subjects and the depressive disorder group. The subscales of terminal insomnia, agitation and loss of insight were significantly different between the minor depressives and major depressives (p<0.01), but no difference between the control subjects and the minor depressives. MMSE total scores were significantly correlated in major depressive disorders among the 3 groups. Comparing subscales of the three groups, significant correlation were found in time orientation, attention and calculation (p<0.05) and language (p<0.01). CONCLUSION: Major depressive disorder patients in elderly medical inpatients chiefly complained of depression and anxiety, but they also complained somatic symptoms. If elderly medical inpatients complain of agitation, terminal insomnia, cognitive impairment associated with depressive symptoms, consultants will pay attention for the major depressive disorders. This study suggests that further systematic study is necessary for the recognition of major depressive disorder in the elderly medical inpatients.
Aged* ; Anxiety ; Body Weight ; Consultants ; Depression ; Depressive Disorder* ; Depressive Disorder, Major* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Dihydroergotamine ; Female ; Hospitals, General ; Humans ; Inpatients* ; Male ; Prospective Studies ; Sleep Initiation and Maintenance Disorders

Schwannoma is a benign encapsulated nerve sheath tumor and is histologically characterized by a mixture of Antoni type A and B tissue. A preoperative diagnosis of schwannoma by fine needle aspiration cytology or by any other means is important to preserve clinically important nerves. Therefore, it is necessary to make a specific cytological diagnosis of nerve sheath tumor. However, there are a few reports regarding cytological features of schwannoma in Korea. We experienced seven cases of solitary schwannoma and here we report their characteristic cytological features with a review of literatures. The characteristic features of schwannoma on cytology were the presence of both Antoni type A and B tissue. The cytologic findings common to all cases of schwannoma generally corresponded to the histologic findings of Antoni type A tissue, consisting of fragments of tightly cohesive fascicles with variable cellularity. Dense fibrillary substances were found, along with palisading nuclei and Verocay bodies. Individual tumor cells consisted of cohesive cells having spindle or oval nuclei, with pointed ends and indistinct cell borders. Variation in nuclear size and shape was also present. The Antoni type B consisted of scattered wavy or short spindle cells and some histiocytes and lymphocytes in the abundant myxoid background with formation of microcysts. Immunohistochemistry for S-100 protein revealed a uniformly strong positive reaction and was helpful to make more accurate diagnosis of schwannoma.
Hemangioma

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

The autoinfective filariform larva of Strongyloides stercoralis causes hyperinfection in immunosuppressed hosts. Here we report on the case of a male patient who was admitted to the emergency room at Gwangju Veterans Hospital with a complaint of dyspnea, and who was receiving corticosteroid therapy for asthma. Many slender larvae of S. stercoralis with a notched tail were detected in Papanicolaou stained sputum. They measured 269 +/- 21.2 micrometer in length and 11 +/- 0.6 micrometer in width. The esophagus extended nearly half of the body length. The larvae were identified putatively as autoinfective third-stage filariform larvae, and their presence was fatal. The autoinfective filariform larva of S. stercoralis has not been previously reported in Korea.
Aged ; Animals ; Fatal Outcome ; Humans ; Immunocompromised Host ; Larva ; Male ; Sputum ; Strongyloides/growth & development/*isolation & purification ; Strongyloidiasis/*etiology ; Superinfection/*parasitology

Background: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. Case: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1–2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. Conclusions It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.