Chronic sclerosing sialadenitis, Mikulicz disease or Kuttner tumor has been recently recognized as a spectrum of IgG4-related sclerosing disease. IgG4-related disease is characterized by a high serum IgG4 level and tissue infiltration of IgG4-positive plasmacytes. We report three cases of chronic sclerosing sialadenitis with variably associated systemic involvement. All patients presented with a submandibular mass or swelling, and all the resected submandibular glands showed diffuse lymphocytic infiltration, lymphoid follicles, and septal fibrosis. Two of the specimens revealed numerous IgG-positive plasma cells, most of which were IgG4-positive on immunohistochemical staining. One of them was associated with dacryoadenitis and hypophysitis. The other patient had ureterorenal lesions. Immunohistochemical study was unavailable in remaining one case, but the histologic features along with elevated IgG level and associated pancreatitis supported the diagnosis. All patients received steroid therapy postoperatively and are doing well. Salivary gland involvement in IgG4-related fibrosclerosis should be recognized in systemic medical pathology.
Dacryocystitis ; Fibrosis ; Humans ; Immunoglobulin G ; Mikulicz' Disease ; Pancreatitis ; Plasma Cells ; Salivary Glands ; Sialadenitis ; Submandibular Gland

"We retrospectively reviewed the results of 1,850 fine needle aspiration cytology (FNAC) of thyroid nodules performed from 1990 to 1991 in the Department of Pathology, Seoul National University Hospital. Among 1,528 cases and 322 cases aspirated by clinicians and a pathologist, 465 cases (30.4%) and 13 cases (4.0%) of the aspirates were inadequate, respectively. In 227 cases, correlation of the FNAC diagnosis and histologic diagnosis was done. Excluding the inadequate cases, the sensitivity for the detection of neoplasm (malignancy together with follicular adenoma) was 86.4% and the specificity was 70.7%. The overall diagnostic accuracy was 79.0%. There were 16 false-positive cases (7.0%), and 19 false-negative cases (8.4%). The predictive value of each cytologic diagnosis was 92% in papillary carcinoma, and 100% in Hashimoto's thyroiditis. The expectancy of malignancy was 52.8% in ""suspicious malignancy"" and 26.7% in ""atypical lesion""."
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Pathology ; Retrospective Studies ; Sensitivity and Specificity ; Seoul ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis

PURPOSE: To evaluate the short-term therapeutic effectiveness of ovarian vein embolization using coils for pelvic congestion syndrome (PCS), a common cause of chronic pelvic pain, and to determine patient satisfaction. MATERIALS AND METHODS: Forty-four multiparous women aged 26-73 (mean, 39.9) years in whom chronic pelvic pain due to unknown causes had lasted for more than six months, and whose gynecologic findings and laboratory data suggested PCS, underwent transabdominal or transvaginal ultrasonography and selective ovarian venography. PSC was finally diagnosed in 21 of th 44, who underwent 22 ovarian vein embolizations (in one case, bilaterally). The simple pain rating system was used at admission, with a 'minimal' or 'moderate' grade representing discomfort in daily life, and 'severe' indicating the need for medication. Indications for coil embolization included dilatation of the ovarian vein to a diameter of more than 6 mm, reflux involving an incompetent valve, congestion of the pelvic venous plexus (involving the stasis of contrast media), and/or opacification of the ipsilateral internal iliac vein (or contralateral filling). Embolizations were undertaken using coils of optimal size and number, and the mean follow-up period was 217 (31-267) days. By means of a telephone questionnaire, the outcome was classified as a cure, pain reduction, or 'no change, or aggravation', and on the basis of whether or not they would opt for the same treatment, or recommend embolization to others, patient satisfaction was graded as 'substantial', 'moderate', or 'absent. RESULTS: Venous occlusion was confimed at postembolization venography in all 22 cases. Clinical treatment led to symptomatic relief in 76.2% of patients a cure in 33.3% (7/21), pain reduction in 42.9% (9/21) and no imchange, or aggravation, in 23.8% (5/21). Eighteen patients (85.8%) were very (9/21, 42.9%) or moderately (9/21, 42.9%) satisfied with coil embolization. In two, the coil migrated, and was successfully retrieved using a snare loop. CONCLUSION: In this study, ovarian vein embolization using coils for PCS appeared to be both safe and effective in controlling pain. If other causes of pelvic pain are absent, it is thought to be a valuable alternative to surgical procedures.
Dilatation ; Embolization, Therapeutic ; Estrogens, Conjugated (USP)* ; Female ; Follow-Up Studies ; Humans ; Iliac Vein ; Patient Satisfaction ; Pelvic Pain ; Phlebography ; Surveys and Questionnaires ; SNARE Proteins ; Telephone ; Ultrasonography ; Veins*

PURPOSE: To report a case of corneal and lenticular pigmentation after prolonged clozapine therapy. CASE SUMMARY: A 56-year-old male visited our hospital with a progressive decline in vision that affected both eyes. He had a history of schizophrenia. He was being treated with 200 mg clozapine and 1 mg lorazepam daily, and had been treated with clozapine for 5 years. At the first visit, his best-corrected-visual acuity was 20/32 in both eyes. Slit lamp examination of the corneas showed bright, fine, grayish-brown deposits on the endothelium, and on dilation, bilateral central stellate opacity of the anterior portion of the lens capsule was revealed. CONCLUSIONS: Clozapine may induce corneal and lenticular pigmentation and thus may lead to a decline in vision. Patients on long-term clozapine therapy should be considered for regular ophthalmic review.
Clozapine ; Cornea ; Endothelium ; Humans ; Lorazepam ; Male ; Middle Aged ; Pigmentation ; Schizophrenia ; Slit Lamp

To better understand the relationship between specific chromosome changes found in human lung tumors and their phenotypic consequences a the tissue level, an in situ hybridization (ISH) procedure of chromosome 17 and immunohistochemistry of proliferating cell nuclear antigen (PCNA) were done. The deparaffinized sections were stained with pericentromeric probes for chromosome 17 and an immunohistochemical study of a monoclonal antibody against PCNA were performed. The numbers of chromosome signals were than compared with the positivity of PCNA expression. The mean numbers of chromosome were 1.62 in normal lymphocytes and 2.48 in lung cancer cells. Tumors showed a high mean positivity of PCNA of 43.4%. Mean PCNA expression was higher in squamous carcinomas than in adenocarcinomas (p<0.05). A linear correlation between numbers of ISH signals and PCNA expression was not demonstrated, but there was a tendency of increasing PCNA positivity according to increasing numbers of ISH signals in adenocarcinomas of the lung and the tumor tissues which were over 50% positive PCNA expression. There was no linear correlation between numbers of ISH signals, PCNA positivity and tumor stages, and keratinization of squamous cell lung cancer. These results suggest that ISH will prove to bo an important tool for determining the underlying genetic basis for tissue phenotypic heterogeneity by allowing genetic determinations to be made on paraffin-embedded tissue sections where histologic architecture is preserved, and immunohistochemical nuclear staining with anti-PCNA on routinely processed tissue is a simple technique for the assessment of proliferation in non-small cell lung carcinoma.
Antigens, Neoplasm/analysis ; Cell Differentiation/physiology ; Cell Division/physiology ; Chromosome Aberrations/*physiology ; *Chromosomes, Human, Pair 17 ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Lung Neoplasms/*genetics/pathology ; Neoplasm Staging ; Nuclear Proteins/analysis ; Phenotype ; Proliferating Cell Nuclear Antigen

OBJECTIVE: The aim of this study was to evaluate the effect of Pentoxifylline(PF) on the conventional ICSI program undergone in severe asthenozoospermia. METHOD: Total 348 cycles of ICSI programs undertaken at CHA General Hospital from January, 1996 to September, 2000, were divided into two groups - injected with pentoxifylline-treated sperm(PFT, 204 cycles) or non-treated sperm(NPFT, 144 cycles) and the clinical results of PFT group were compared with those of NPFT. RESULTS: PF-treatment on sperm increased their motility of normozoospermia and severe asthenozoospermia. Fertilization rate of PFT group was higher than those of ICSI programs undertaken using sperm of NPFT(70.6% vs. 62.9%, p<0.01). And, ET and clinical pregnancy rates of PFT were slightly higher than those of NPFT(93.1%, 44.2% vs. 90.3%, 36.2%). CONCLUSION: These results showed that treatment of pentoxifylline has a beneficial role on selection of viable sperm in severe asthenozoospermia.
Asthenozoospermia* ; Fertilization ; Hospitals, General ; Pentoxifylline* ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic* ; Spermatozoa

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly due to M llerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patient. The simple and adequate treatment of the condition is incision of the obstructed vaginal septum providing adequate drainage of the retained blood. We report a case of uterus didelphys with obstructed hemivagina with brief review of the literature.
Diagnosis ; Drainage ; Dysmenorrhea ; Female ; Fertility ; Humans ; Menarche ; Pelvic Pain ; Uterus*

PURPOSE: To describe the technical features of CT-guided percutaneous ethanol injection therapy (PEIT) for hepatic tumors that are undetectable or inaccessible under ultrasound guidance, to analyze its short-term therapeutic results, and to discuss its feasibility and limitations with a review of the related literature. MATERIALS AND METHODS: During a 22-month period, 17 patients with 28 hepatic tumors (27 hepatocellular carcinomas and one metastasis) underwent 38 sessions of CT-guided PEIT. Follow-up CT scanning was also performed. All tumors were undetectable or inaccessible under ultrasound guidance. The quantity of ethanol injected depended on their maximum diameter, which was 0.9 -5.1 (mean, 2.2) cm. To determine the puncture site and direction of the needle, the graduated grid system was used. A 21 or 22-G PEIT needle was introduced into the tumor stepwise, with intermittent CT monitoring, and if the CT images obtained immediately after initial injection demonstrated incomplete perfusion, an additional dose of ethanol was administered. During the follow-up period of 28 -619 (mean, 261) days, three-phase spiral CT scans were obtained. We focused on whether or not a viable portion of ablated tumor was present, and if so, the interval during which the extent of viable portion had changed, as well as the CT findings which suggested a predisposition to incomplete ablation. RESULTS: PEIT was successfully performed in all patients. During each session, 3 -30 (mean, 12.1) mL of ethanol was injected for 35 -115 (mean, 85) mins, with 1 -7 (mean, 3.7) trials to determine the puncture site and needle direction. The follow-up CT results showed that 20 tumors (71.4%) contained no viable portion, that this portion had decreased in four (14.3%), and was unchanged or had increased in four (14.3%). In the eight tumors for which multiple sessions were required, follow-up CT showed that the viable portion was absent or had decreased in size in all except one. In five of the patients with a tumor containing a viable portion at follow- up CT, the procedure was incomplete because of unendurable pain (n = 2) or noncooperation (n = 3). A CT finding which suggested a predisposition to incomplete ablation was a poor margin (n = 3). Complications included severe pain (n = 6) and scanty peritoneal hemorrhage (n = 1). CONCLUSION: Despite several limitations of our study, the therapeutic results of CT-guided PEIT appeared to be similar to or slightly worse than those of well-established ultrasound-guided PEIT with the former procedure, however, intermittent CT monitoring indicates whether perfusion is complete, and for this reason, CT-guided PEIT is believed to be an effective treatment modality when a hepatic tumor is undetectable or inaccessible under ultrasound guidance.
Carcinoma, Hepatocellular ; Ethanol* ; Follow-Up Studies ; Hemorrhage ; Humans ; Needles ; Perfusion ; Punctures ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: The literature on variations of rib is limited. Very little has been written in the radiological journal of this country on the subject. It seemed of interest to investigate the nature and incidence of congenital variations in a series of routine chest roentgenograms. The topic of rib variations has not been covered extensively in the radiological journals in Korea. This has presented an opportunity to investigate the nature, type, shape and incidences of congenital rib variations in normal Korean adults from a series of routine roentgenograms. METHODS: Chest radiographs of 5,000 adults (,) who visited our hospital for a routine check-up or for employment physical examinations from January 1996 to September 1998, were consecutively reviewed. The sex distribution consisted of 2,827 male males and 2,173 females (ratio of 1.3:1) with the age range between 19 and 65 years (mean age: 34.6 years). The chest PAs was were analyzed for the presence, type, location, and shape of the rib variations (.) From this data, and we the incidence of each type of variations was calculated. RESULTS: Seventy-six of the 5000 adults (1.52%), 63 male (2.23%) and 13 female (0.6%), showed 88 cases of rib variation (Table 1). Bifid rib (n=35) was the The most common variation was the bifid rib (n=35), followed by hypoplasia of the rib (n=22), flaring of the rib (n=18), bridging of the ribs (n=7), cervical ribs (n=3), and fusion of between ribs (n=3) (Table 2). (New paragraph)Bifid The bifid rib (Table 1) was found most frequent in the right fourth rib (12/35, 34.3%), followed by the left fifth rib (6/35, 17.1%) and right third rib (6/35, 17.1%). Hypoplasia of the rib was common in first rib (20/22, 90.9%). Flaring of the rib was common at fourth rib (8/18. 44.4%, right and left combined) (,) and bridging between ribs was common between first and second rib (3/7, 42.9%). CONCLUSION: The percentage of incidence of rib variations in adults was 1.52%. Bifid rib was the most common variation, followed by hypoplasia, flaring, bridging, cervical rib, and fusion of ribs(,) in decreasing order.
Adult ; Cervical Rib ; Employment ; Female ; Humans ; Incidence* ; Korea ; Male ; Physical Examination ; Radiography ; Radiography, Thoracic* ; Ribs* ; Sex Distribution ; Thorax*

Nowadays, digital dentistry is generally applied to prosthodontics with fabrication of inlays or any other fixed prostheses by utilizing CAD/CAM (computer-aided design/computer-aided manufacturing) technology and intraoral scanner. However, in fabricating removable prosthesis, there are some limitations for digital technology to substitute conventional casting method. Therefore, approaching removable prostheses fabrication with CAD/CAM technology would be a meaningful trial. In this case report, Kennedy class III mandibular edentulous patient who was in need of increasing the vertical dimension of occlusion was treated with removable partial denture using CAD and rapid prototyping technique. Surveying and designing the metal framework of the partial denture was performed with CAD, and sacrificial plastic pattern was fabricated with rapid prototyping technique. During the follow up period of nine months, the removable partial denture has provided satisfactory results in esthetics and function.
Computer-Aided Design* ; Dentistry ; Denture, Partial ; Denture, Partial, Removable ; Esthetics ; Follow-Up Studies ; Humans ; Inlays ; Methods ; Plastics ; Prostheses and Implants ; Prosthodontics ; Vertical Dimension