Exfoliative cytology of synovial fluid is less stressed in medical practice, but it can be a very useful tool for the differential diagnosis of various joint diseases. This report describes a case of juvenile rheumatoid arthritls in a 7 year old girl, who showed characteristic ragocytes in joint fluid. Synovial biopsy specimen confirmed the diagnosis of rheumatoid arthritis.
Diagnosis, Differential ; Biopsy

No abstract available.
Accidents, Traffic* ; Aggression*

Experimental allergic encephalomyelitis (EAE) has been a well established animal model of postvaccinatal demyelinating diseases occurring in humans. Therefore elucidation of its pathogenesis would be very critical for the understanding of various human demyelinating diseases including multiple sclerosis. This study was performed to characterize the infiltrating cells in inflammatory sites and analyze the nature of the damage of blood brain barrier in experimental allergic encephalomyelitis. Experimental allergic encephalomyelitis was produced by administering homologous spinal cord homogenate together with complete Freund's adjuvant in guinea pigs. Immunostainings on guinea pig IgG, IgM, IgA and muramidase were performed by peroxidase-antiperoxidase or indirect immunofluorescent methods. The blood-brain barrier change was assessed by administering fluorescent Evans blue. Following results were made. In juvenile animals, both clinical findings and histopathologic changes were first noted by 3 weeks after injection and progressed during the whole experimental period. However, these findings were delayed in onset and low in incidence in adult animals. The clinical and pathologic changes started from the caudal portions and extended rostrally. The blood-brain barrier (BBB) was damaged and progressed starting also from the caudal portion of the spinal cord. The BBB changes were more severe in young animal than adult animals. Those changes preceded th histologic alterations. It is suggested that the BBB susceptibility is responsible for the caudal onset of histologic changes. Although the lesion has been thought to be induced by T-cell mediated hypersensitivity, infiltrating cells consisted mainly of muramidase positive histiocytes. A few immunoglobulin positive B cells or plasma cells could also be demonstrated in the lesion. The former usually infiltrated the parenchyme and the latter remained around the small or medium-sized vessels.
Adult ; Male ; Female ; Humans ; Animals ; Incidence

Atresia of larynx is a rare fatal anomaly that should bring an immediate medical attention for proper managenent. We reported a case who died in neonatal period because of respiratory difficulty. His first problem was difficulty of inserting tracheal tube through the larynx. It was of interest in this case that he was presented with generalized edema and also massive lung edema. The lung was characterized by total absence of squamous and amniotic debris in the alveolar spaces and massive inflation of the alveoli by clear fluid that was thought to be amniotic fouid produced by the lung per se. Because there was no connection between oral cavity and the lungs, there would be no way the amniotic fluid outside the fetus. The laryngeal atresia was of infraglottic type and was complete with dispalced cricoid cartilage. Associated anomalies were left persistent supperior vena cava, perimembranous ventricular septal defect, spina bifida and focal cerebellar heterotopia.
Infant, Newborn ; Humans

Primary oxalosis is a rare genetic disorder caused by a deficiency of the peroxisomal enzyme alanine-glyoxylate aminotransferase(type I) and D-glyceric dehydrogenase(type II). It is characterized by the triad of radiopaque urolithiasis, nephrocalcinosis, and latered renal function. We report a case of primary oxalosis in a 10-year-old Korean girl. She presented with chronic renal failure at 9 years of age. Ultrasonographic examination revealed bilateral, multiple renal and ureteral stones. Removed stones were chemically analysed to be composed of calcium oxalate. She underwent renal transplantation after prolonged period of dialysis. Removed kidneys were firm and gritty. Cut sections showed numerous tiny yellow sandy stones and a large staghorn stone. Specimen X-ray also exhibited disseminated fine granular and often coalescent radiopaque materials throughout the cortex and medulla. Microscopically numerous varying-sized crystals were noted in the kidney in globular or rhomboid appearance. The crystals were semitranslucent and doubly refractile under the polarized light. Diffuse interstitial fibrosis and chronic inflammation as well as glomerular obsolescence were also noted. The oxalate deposit was diffuse and marked, and was thought to be intimately related to the parenchymal damage and fibrosis.

No abstract available.
Child* ; Humans ; Melanoma*

PURPOSE: The aim of our study was to evaluate the usefulness of MR imaging in cases of traumatic brachial plexus injury. MATERIALS AND METHODS: We evaluated 25 patients with traumatic brachial plexus injury as seen on MR images prior to surgical exploration and repair. MR images were retrospectively evaluated for nerve root avulsion and pseudomeningocele, and postganglionic lesions. Results were correlated with final diagnosis after surgical exploration . RESULTS: One hundred and four of 125 root levels (83%) were adequately imaged. Neve root avulsion was shown at 28 levels(54%). Avulsion with or without pseudomeningocele was seen at 37 levels(71%)(80% sensitivity, 91% specificity). The presence of ten of 12 postganglionic lesions (83%) was revealed by MR imaging. CONCLUSION: MR imaging is valuable for revealing preganglionic nerve root avulsion in patients with traumatic brachial plexus injury or postganglionic lesions.
Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

PURPOSE: The aim of our study was to evaluate the usefulness of MR imaging in cases of traumatic brachial plexus injury. MATERIALS AND METHODS: We evaluated 25 patients with traumatic brachial plexus injury as seen on MR images prior to surgical exploration and repair. MR images were retrospectively evaluated for nerve root avulsion and pseudomeningocele, and postganglionic lesions. Results were correlated with final diagnosis after surgical exploration . RESULTS: One hundred and four of 125 root levels (83%) were adequately imaged. Neve root avulsion was shown at 28 levels(54%). Avulsion with or without pseudomeningocele was seen at 37 levels(71%)(80% sensitivity, 91% specificity). The presence of ten of 12 postganglionic lesions (83%) was revealed by MR imaging. CONCLUSION: MR imaging is valuable for revealing preganglionic nerve root avulsion in patients with traumatic brachial plexus injury or postganglionic lesions.
Brachial Plexus* ; Diagnosis ; Humans ; Magnetic Resonance Imaging* ; Radiculopathy ; Retrospective Studies

The epidermoid cyst of the testis is a rare benign lesion with a characteristic gross and microscopic appearances. This 25 year old male who had been previously diagnosed as Klinefelter's snydrome (47/XXY) had right orchiectomy due to hard testicular nodule for a presented malignant testicular tumor. Sectioning of the testis revealed a intraparenchy matous cystic lesion, 1.5 cm in diameter, filled with cheesy white material. Histologically, stratified squamous epithelium lined the cyst. The remaining testis showed advanced tubular sclerosis and Leydig cell hyperplasia. It is necessary to submit multiple sections to rule out other histologic elements in the cyst wall or the presence of a scar. Although epidermoid cyst occurring as a solitary testicullar nodule could be regarded as a stage in the development of a teratoma, they need to be distinguished from the complex differentiated teratomas because of a distinct difference in prognosis.
Male ; Humans ; Cysts

BACKGROUND: Survival time of patients with multiple myeloma has been reported to be closely related to the cytology of bone marrow smears and the histologic features of bone marrow biopsies. However, there have been many differences in morphological criteria applied by various authors. In this study, we evaluated the prognostic relevance of bone marrow features in patients with multple myeloma by investigation of the cytologic feature and the histologic patterns. MATERIALS AND METHODS: One hundred and seven previously untreated patients with multiple myeloma, admitted to Asan Medical Center, between 1989 and 1997, were studied. Bone marrow aspirations and biopsies were analyzed according to the criteria such as cytologic differentiation, volume of infiltration, pattern of infiltration, degree of hematopoiesis, and presence of fibrosis. RESULTS: 64 cases (59.8%) of 107 patients with multiple myeloma were plasmacytic type and 43 cases (40.2%) were plasmablastic type. Each median survival time was 35.0 months and 18.0 months (P<0.05). The patients with more than 25% of plasmablasts showed shorter median survival time than those with 1ess than 25% (18 months vs 38.9 months, P<0.05). The patients with nodular or packed marrow pattern revealed poorer prognosis than those with interstitial or interstitial/nodular pattern (P<0.05). The patients of plasmablastic type disclosed larger volume of myeloma cell infiltration and more packed marow pattern than those of plasmacytic type. CONCLUSIONS: The cytologic differentiation, the volume of infiltration and the patterns of infiltration were reliable predictors of survival in myeloma patients. Thus, for the prognostic evaluation and therapeutic plans, the descriptions for cytologic differentiation (especially percentage of plasmablasts), volume of infiltration and pattern of infiltration should be included in the bone marrow interpretation of multiple myeloma.
Aspirations (Psychology) ; Biopsy ; Bone Marrow* ; Chungcheongnam-do ; Fibrosis ; Hematopoiesis ; Humans ; Multiple Myeloma* ; Prognosis