Vasculitis, characterized by inflammation of vessel walls, is comprised of heterogeneous clinicopathological entities, and thus poses a diagnostic challenge. The most widely used approach for classifying vasculitides is based on the International Chapel Hill Consensus Conference (CHCC) nomenclature system. Based on the recently revised CHCC 2012, we propose computed tomography (CT) features of vasculitides and a differential diagnosis based on location and morphological characteristics. Finally, vasculitis mimics should be differentiated, because erroneous application of immunosuppressive drugs on vasculitis mimics may be ineffective, even deteriorating. This article presents the utility of CT in the diagnosis and differential diagnosis of vasculitides.
Classification* ; Consensus* ; Diagnosis ; Diagnosis, Differential ; Inflammation ; Vasculitis*

The majority of dry eye symptoms are due to a chronic inflammation of the lacrimal functional unit resulting in a loss of tear film integrity and normal function. The tear secretion is controlled by the lacrimal functional unit consisting of the ocular surface (cornea, conjunctiva, and meibomian glands), the main lacrimal gland, and the interconnecting innervation. A lack of systemic androgen support to the lacrimal gland has been shown to be a facilitating factor in the initiation of ocular inflammation. If any portion of this functional unit is compromised, lacrimal gland support to the ocular surface is impeded. In this review, the classification and treatment of dry eye syndrome will be presented according to the A Delphi approach.
Classification ; Conjunctiva ; Cyclosporine ; Dry Eye Syndromes ; Inflammation ; Lacrimal Apparatus ; Tears

The glaucomatocyclitic crisis was first described by Posner and Schlossman in 1948, and belongs to the classification of secondary open angle glaucoma. It is unilateral and recurrent. and characterized by minimal inflammatory signs and symptoms. The inflammation may be confined to the trabecular mesh work. The facility of outflow reduced while attacks last from a few hours to over 2 weeks. Etiopathogenic nature of glaucomatocyclitic crisis is not clear but recently the role of allergy is suggested in this disease entity. A 35 year old man was found to have a glaucomatocyclitic crisis in his right eye that was treated with systemic diamox and topical corticosteroid.
Acetazolamide ; Adult ; Classification ; Glaucoma, Open-Angle ; Humans ; Hypersensitivity ; Inflammation

BACKGROUND: Rosacea is characterized by erythema of the face that persists for several months or longer. Rosacea is usually diagnosed based on clinical presentation and a biopsy is rarely performed for diagnostic purposes. However, a biopsy may be helpful when the symptoms are atypical. OBJECTIVE: We identified commonly appearing histological characteristics of rosacea such as inflammation, sebaceous hyperplasia, granulomatous reaction, epidermal hyperplasia, Demodex, pustules, and fibrosis. In addition, we evaluated these according to clinical subtype. METHODS: We examined the histological findings of 200 rosacea patients who visited our hospital. Histological findings were evaluated according to clinical subtype. The standard classification and staging method published by the National Rosacea Society was used for clinical classification. RESULTS: The erythematotelangiectatic and papulopustular types of rosacea were the most common. Mild inflammation was found in 56.0% of the patients (1 and 1+) and 49.0% showed inflammation greater than 2 degrees. The most commonly observed histological features across all subtypes were sebaceous hyperplasia followed by epidermal hyperplasia and Demodex. However, sebaceous hyperplasia and Demodex were not observed in ocular rosacea. CONCLUSION: Some histological findings such as inflammation, granulomatous reaction, sebaceous hyperplasia, pustule, Demodex, epidermal hyperplasia, and fibrosis were commonly observed in rosacea. There were no distinctive subtype-specific characteristics, but various histological characteristics were observed in a single clinical subtype.
Biopsy ; Classification ; Erythema ; Fibrosis ; Humans ; Hyperplasia ; Inflammation ; Rosacea*

Colitis, Ulcerative ; classification ; diagnosis ; pathology ; Humans ; Inflammation ; Medicine, Chinese Traditional

BACKGROUND/AIMS: The indications for colorectal endoscopic submucosal dissection (ESD) vary in clinical practice. To establish colorectal ESD as a standard treatment, standard indications are essential. For establishing standard indications for colorectal ESD, we surveyed the preferences and criteria of endoscopists for colorectal ESD in their practices. METHODS: A multiple-choice questionnaire was sent to 27 members of the Korean Society of Gastrointestinal Endoscopy/ESD group. The indications of endoscopists for selecting ESD as a treatment for colorectal tumors ≥2 cm in diameter were surveyed. RESULTS: On the basis of the preprocedural assessment of histology, adenoma with high-grade dysplasia, mucosal cancer, and shallow submucosa invasive cancer were included in the indication for ESD. Based on gross morphology, laterally spreading tumor (LST) granular nodular mixed type, LST-nongranular (LST-NG) flat elevated type, and LST-NG pseudodepressed type were included. On the basis of the pit pattern by Kudo classification, types III, IV, and V-I were included. Based on the narrow band imaging pattern by Sano classification, types II and III-a were included. Other lesions, such as sporadic localized tumors in chronic inflammation and local residual early carcinoma after endoscopic resection, were also included in the indication for ESD. CONCLUSIONS: The indications of Korean endoscopists for colorectal ESD are broader than those in recent guidelines, and tend to include more benign-looking tumors. To find the appropriate indications for colorectal ESD, systematic data collection and analysis are required to reach a consensus in a timely manner.
Adenoma ; Classification ; Colorectal Neoplasms* ; Consensus ; Data Collection ; Inflammation ; Narrow Band Imaging

SLE is an autoimmune disease with multiorgan involvement and a wide range of clinical manifestations, and inflammation of gallbladder also can be represented. There were a few cases of acute acalculous cholecystitis (AAC) in previous reports. Most of them tended to already know about underlying SLE when detected AAC at that time. It may be difficult to detect AAC caused by SLE not due to biliary stone if physician is not conscious of undiagnosed lupus. We introduce a 70-year old female patient, who is diagnosed with AAC. Her symptoms were satisfied the ACR classification criteria for SLE, and was diagnosed with SLE, simultaneously. After a high dose steroid pulse therapy, followed by cyclophosphamide, her symptoms have improved rapidly. In order to better diagnose and treat the disease, we need to be aware of AAC as a potential manifestation of SLE.
Acalculous Cholecystitis* ; Autoimmune Diseases ; Cholecystitis ; Classification ; Cyclophosphamide ; Female ; Gallbladder ; Humans ; Inflammation ; Lupus Erythematosus, Systemic*

Megaureter literally means a large ureter and is not used to denote a specific disease process. In this report a classification was proposed according to International pediatric urologic seminar in 1976. Seven cases of primary obstructive megaureter were presented with literature. This diagnosis excluded infravesical obstruction, reflux and neurogenic disorders. The results were as follows; 1. 6 cases were left, 1 case was bilateral. 2. The symptom of pyuria was observed in 2 cases, flank pain and pyuria were observed in 2 cases hematuria was observed in 2 cases, abdominal distention was observed in 1 cases. 3. Histologic findings showed inflammation of mucosa and submucosa in 3 cases, submucosal fibrosis and muscular hypertrophy in 2 cases and submucosal fibrosis and inflammation in 2 cases. 4. 6 cases were treated by Politano-Leadbetter ureteroneocystostomy and 1 case of them was tailored 1 case was treated by nephrourethrectomy. 5. Follow up study was performed in 5 cases of Politano-Leadbetter ureteroneocystostomy. 4 cases of them showed improved pyuria and hydroureteronephrosis.
Classification ; Diagnosis ; Fibrosis ; Flank Pain ; Follow-Up Studies ; Hematuria ; Hypertrophy ; Inflammation ; Mucous Membrane ; Pyuria ; Ureter

Transplant glomerulopathy (TG) is a special form of glomerular injury in renal allografts. It affects varying proportions of glomeruli, which may have an influence on the amount of proteinuria or graft survival. We reviewed 32 cases of TG to evaluate histologic changes and graft outcome. The severity of TG as well as acute and chronic changes of the glomerular, tubulointerstitial and vascular compartment were scored according to Banff classification. There were 17 cases of cg1, 3 cases of cg2 and 12 cases of cg3. There was no significant difference in age, duration of transplant at time of biopsy and duration of follow-up between groups. Serum creatinine level and the degree of proteinuria were higher in cg3 and statistically significant. However, there was no difference in the degree of glomerulosclerosis, interstitial inflammation, fibrosis, tubular atrophy or vascular wall thickening between groups. Graft failure was present in 13 cases, mostly due to chronic rejection including sepsis and CMV infection in one case each. Five-year graft survival was 84.1% and was not significantly different from cases without TG. In conclusion, the severity of TG indicates profuse proteinuria, but does not affect graft outcome, which indicates tubulointerstitial and vascular pathology as being a more important prognosticator.
Allografts ; Atrophy ; Biopsy ; Classification ; Creatinine ; Fibrosis ; Follow-Up Studies ; Graft Survival* ; Inflammation ; Pathology ; Proteinuria* ; Sepsis ; Transplants*

PURPOSE: Laparoscopic cholecystectomy (LC) has become the standard procedure for gallbladder disease. LC is associated with bile duct injury, which can cause serious complications. We evaluate the treatment, results and the relation with cholangiopancreatography for bile duct injury during LC. METHODS: 860 cases of LC were performed from April 2000 to August 2005. Among them, 7 cases of bile duct injury were reviewed for the diagnosis, management and operation findings. RESULTS: According to the Strasberg classification, there were 5 cases of type E, 1 case of type C and 1 case of type D. All of them were identified at operation and they were immediately managed. Among the type E cases, the type E1 was managed by CBD end-to-end anastomosis with internal drainage, type the E2 and type E3 were managed by Roux-en-Y hepaticojejunostomy, the type C were managed by primary repair with T-tube drainage and the type D were managed by primary repair. Although all of cases were visible at the cystic duct on preoperative cholangiopancreatography, we could not identify the type E on the operation findings. CONCLUSION: In this study, although the cystic duct was identified on cholangiopancreatography preoperatively, the possibility of bile duct injury increases if there was severe inflammation and adhesion. For the management of bile duct injury, we recommend CBD end-to-end anastomosis for type E1, Roux-en-Y hepaticojejunostomy for type E2 and E3, and primary repair and/or drainage for type C and D.
Bile Ducts* ; Bile* ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Classification ; Cystic Duct ; Diagnosis ; Drainage ; Gallbladder Diseases ; Inflammation ; Laparoscopy