Adenomatoid tumors are well-recognized neoplasms generally to be of mesothelial derivation. We experienced a case of an adenomatoid tumor of the tail of the epididymis in a 56-year-old male. Grossly the tumor was firm and whitish gray, and microscopically it consisted of glandular, cord-like, microcystic structures which were lined by flattened endothelial like to plump cuboidal cells. Immunohistochemical stains whowed positivity for keratin and negativity for facter VIII related antigen and carcinoembryonic antigen. Ultrastructually, there was many long microvilli projecting into the glandular lumina and intracytoplasmic luminal spaces, desmosomes, and prominent cytoplasmic tonofilaments. Those findings strongly support the mesothelial origin of the adenomatoid tumor especially in the glandular type. It also lead us to suggest that the term adenomatoid tumor should be remain in use for light microscopic diagnosis, and that the term adenomatoid mesothelioma should be applied when the mesothelial nature of an adenomatoid tumor is proven by electron microscopy and immunohistochemical stains.

ARheumatoid arthritis is a systemic, inflammatory, autoimmune disorder of unknown origins. Enhanced understanding of molecular pathogenesis has enabled the development of new biologic treatment that focuses on selective parts of immune system. Combined genetic and environmental factors in association with the risk of rheumatoid arthritis have received increased attention. Research undertaken on the longitudinal disease process and molecular pathology of joint inflammation has contributed to the development of new therapeutic strategies that promote early use of disease-modifying anti-rheumatic drugs (DMARDs) with tight disease control and measurable treatment outcome. Such approach can be beneficial for control of inflammatory activity and joint destruction. We need to find out how to tailor the best individualized treatment in accordance with different cases.
Antirheumatic Agents ; Arthritis ; Arthritis, Rheumatoid ; Immune System ; Inflammation ; Joints ; Pathology, Molecular ; Treatment Outcome

ARheumatoid arthritis is a systemic, inflammatory, autoimmune disorder of unknown origins. Enhanced understanding of molecular pathogenesis has enabled the development of new biologic treatment that focuses on selective parts of immune system. Combined genetic and environmental factors in association with the risk of rheumatoid arthritis have received increased attention. Research undertaken on the longitudinal disease process and molecular pathology of joint inflammation has contributed to the development of new therapeutic strategies that promote early use of disease-modifying anti-rheumatic drugs (DMARDs) with tight disease control and measurable treatment outcome. Such approach can be beneficial for control of inflammatory activity and joint destruction. We need to find out how to tailor the best individualized treatment in accordance with different cases.
Antirheumatic Agents ; Arthritis ; Arthritis, Rheumatoid ; Immune System ; Inflammation ; Joints ; Pathology, Molecular ; Treatment Outcome

A drug eruption is any adverse skin reaction caused by a drug used in a normal dose. Celecoxib(Celebrex(R)), a cyclooxygenase(COX) 2 inhibitor, is a new generation non-steroidal anti- inflammatory drug, recently introduced in Korea. It is increasingly used because of significantly lower rate of gastrointestinal injury than typically seen with most other NSAIDs. Cutaneous reactions related to celecoxib are rare and there have been no previous reports in Korea. We report a case of drug eruption probably due to this drug with positive skin tests and wish to underline the possible cutaneous reactions with this new drug.
Anti-Inflammatory Agents, Non-Steroidal ; Drug Eruptions* ; Korea ; Skin ; Skin Tests ; Celecoxib

PURPOSE: To report a case of bilateral peripheral ulcerative keratitis after cataract extraction with a clear corneal incision in a patient with rheumatoid arthritis. CASE SUMMARY: A 67-year-old woman was referred to our clinic with bilateral ocular pain and visual disturbances, 10 days after a cataract extraction in her right eye. The patient had undergone a cataract extraction with clear corneal incision in the left eye and the same procedure was performed in the right eye after 1 week. During the surgery, hyphema occurred because of the iris damage by the phacoemulsification tip. Slit lamp examination showed bilateral peripheral ulcerative keratitis around the incision site and diffused corneal edema. Topical instillation and systemic administration of antibiotic agents were given as treatment but the patient showed no improvement. Corneal culture and smear were performed and showed a negative result. Because the patient was previously diagnosed with rheumatoid arthritis and showed the characteristic finger deformity, she was diagnosed with a sterile peripheral ulcerative keratitis and was treated with oral steroid, sulfasalazine, and steroid eye drop. After 1 month of treatment, epithelial thinning of the cornea and peripheral corneal ulcer stopped progressing and showed corneal re-epithelization. CONCLUSIONS: Because peripheral ulcerative keratitis after cataract extraction with clear corneal incision can occur in a patient with rheumatoid arthritis, caution is necessary to minimize damage by careful manipulation during the operation and requires special attention in preoperative and postoperative management.
Arthritis, Rheumatoid ; Cataract ; Cataract Extraction ; Congenital Abnormalities ; Cornea ; Corneal Edema ; Corneal Ulcer ; Eye ; Female ; Fingers ; Humans ; Hyphema ; Iris ; Phacoemulsification ; Sulfasalazine ; Ulcer

Background: Dengue fever is considered one of the transfusion-transmissible emerging infectious diseases. Dengue fever has been reported every year by the Korea Disease Control and Prevention Agency (KDCA). Because a blood donor screening assay to detect the dengue virus (DENV) as an agent of dengue fever is not performed, the risk of transfusion-transmitted DENV infection needs to be assessed. Methods: This study collected the data of DENV infected cases from the Infectious Disease Portal of the KDCA, the data of blood donors and blood components from the Blood Information Management System of the Korean Red Cross, and the data of travelers to major dengue outbreak countries from the Korean Tourism Organization.All data were from 2016 to 2018. A risk assessment was performed using European Up-Front Risk Assessment Tool (EUFRAT). Results: The risk of DENV-infected red cells and platelet concentrate was higher than that of plasma and apheresis platelet. Nevertheless, the risk of the DENV infected blood component was shown to be less than one case per year for all kinds of blood components. Conclusion All the DENV infected cases in Korea were overseas travelers. Therefore, the risk of transfusiontransmissible DENV infection is very low. On the other hand, continuous observation and monitoring are required because Aedes albopictus as a vector of DENV is found in Korea, and the increase in reported cases may lead to domestic infections.

Background: Dengue fever is considered one of the transfusion-transmissible emerging infectious diseases. Dengue fever has been reported every year by the Korea Disease Control and Prevention Agency (KDCA). Because a blood donor screening assay to detect the dengue virus (DENV) as an agent of dengue fever is not performed, the risk of transfusion-transmitted DENV infection needs to be assessed. Methods: This study collected the data of DENV infected cases from the Infectious Disease Portal of the KDCA, the data of blood donors and blood components from the Blood Information Management System of the Korean Red Cross, and the data of travelers to major dengue outbreak countries from the Korean Tourism Organization.All data were from 2016 to 2018. A risk assessment was performed using European Up-Front Risk Assessment Tool (EUFRAT). Results: The risk of DENV-infected red cells and platelet concentrate was higher than that of plasma and apheresis platelet. Nevertheless, the risk of the DENV infected blood component was shown to be less than one case per year for all kinds of blood components. Conclusion All the DENV infected cases in Korea were overseas travelers. Therefore, the risk of transfusiontransmissible DENV infection is very low. On the other hand, continuous observation and monitoring are required because Aedes albopictus as a vector of DENV is found in Korea, and the increase in reported cases may lead to domestic infections.

BACKGROUND/AIMS: The standard guideline for the management Helicobacter pylori infection in Korean children is not present until now. In present study, we conducted the questionnaire survey to investigate the real situation of H. pylori eradication in children. MATERIALS AND METHODS: Questionnaire concerning the indications of H. pylori eradication, the first choice of treatment modality, the decision method of eradication result, experience of eradication failure, the second choice of treatment modality was sent to doctors who are members of the Korean Society for Pediatric Gastorenterology, Hepatology, and Nutrition. RESULTS: A total of 28 doctors (90.3%) answered the questionnaires among 31 doctors. The most common indication for eradication of H. pylori was peptic ulcer (n=24) followed by chronic abdominal pain (n=17) and positive family history of gastric cancer (n=12). The most common choice of first-line eradication therapy was omeprazole, amoxicillin, clarithromycin triple therapy (n=21) and followed by bismuth subsalicylate, amoxicillin, metronidazole, clarithromycin quadruple therapy (n=7). The results of treatment were judged by C13-urea breath test after 2 months later in 19 doctors (67.8%). Twenty four (85.7%) out of 28 doctors had experienced treatment failure. The most common second-line therapy was the sequential therapy (58.3%, 14 doctors among 24). CONCLUSIONS: This was the first study for the survey of the treatment of H. pylori infection to Korean pediatricians. The results of this study showed that most pediatric gastroenterologists used to treat H. pylori infection according to the textbook and the common use of bismuth-based quadruple therapy for the first-line treatment was notable.
Abdominal Pain ; Amoxicillin ; Bismuth ; Breath Tests ; Child* ; Clarithromycin ; Gastroenterology ; Helicobacter pylori* ; Helicobacter* ; Humans ; Methods ; Metronidazole ; Omeprazole ; Peptic Ulcer ; Pilot Projects* ; Stomach Neoplasms ; Treatment Failure

Pyogenic liver abscess with metastatic septic complications is a rare and serious infectious disease if not treated properly. Pyogenic liver abscesses are caused by bacterial, fungal, or parasitic organisms. Escherichia coli used to be the predominant causative agent, but Klebsiella pneumoniae emerged as a major cause in the 1990s. Liver abscesses are caused by hepatic invasion via many routes, such as, the biliary tree, portal vein, hepatic artery, direct extension, or penetrating trauma. Furthermore, diabetes mellitus and malignant conditions are established important risk factors of K. pneumoniae liver abscesses and of septic metastasis, and several recent studies have asserted that K. pneumoniae liver abscess might be a presentation of occult or silent colon cancer. We report a case of K. pneumoniae liver abscess, metastatic septic pulmonary embolism, and endophthalmitis associated with diabetes and advanced gastric cancer.
Biliary Tract ; Colonic Neoplasms ; Communicable Diseases ; Diabetes Mellitus ; Endophthalmitis ; Escherichia coli ; Hepatic Artery ; Klebsiella pneumoniae ; Liver Abscess* ; Liver Abscess, Pyogenic ; Neoplasm Metastasis ; Pneumonia ; Portal Vein ; Pulmonary Embolism ; Risk Factors ; Stomach Neoplasms*

BACKGROUND: This study compared the following three endoscopic techniques used to treat bladder stones: transurethral cystoscope used with a pneumatic lithoclast or nephroscope used with a pneumatic lithoclast and nephroscope used with an ultrasonic lithoclast. METHODS: Between January 2013 and May 2016, 107 patients with bladder stones underwent endoscopic treatment. Patients were classified into three groups based on the endoscopic techniques and energy modalities used in each group as: group 1 (transurethral stone removal using a cystoscope with pneumatic lithoclast), group 2 (transurethral stone removal using a nephroscope with pneumatic lithoclast), and group 3 (transurethral stone removal using a nephroscope with ultrasonic lithoclast). Baseline and perioperative data were retrospectively com-pared between three groups. RESULTS: No statistically significant intergroup differences were observed in age, sex ratio, and stone size. A statistically significant intergroup difference was observed in the operation time—group 1, 71.3±46.6 min; group 2, 33.0±13.7 min; and group 3, 24.6±8.0 min. All patients showed complete stone clearance. The number of urethral entries was higher in group 1 than in the other groups. Significant complications did not occur in any patient. CONCLUSION Nephroscopy scores over cystoscopy for the removal of bladder stones with respect to operation time. Ultrasonic lithoclast is a safe and efficacious modality that scores over a pneumatic lithoclast with respect to the operation time.