The observation of eosinophilic ascites is uncommon. They can be noted in parasitic disease, malignant condition, vasculitis, idiopathic hypereosinophilic syndrome or allergic disorders including eosinophilic gastroenteritis, which is a rare disease of unknown etiology characterized by massive tissue infiltration of eosinophils in the layers of any area of gastrointestinal[GI] tract. Clinical manifestations are related to the level of the histologic infiltration in the wall, and the segment of the GI tract involved. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea and weight loss. Muscle layer involvements have obstructive symptoms. Subserosal eosinophilic infiltration may result in the development of eosinophilic ascites. We experienced a case of eosinophilic ascites as manifestation of eosinophilic gastroenteritis in a 43-year old man who also had jejunal obstruction. High proportion of eosinophil count was noted in the ascites, however peripheral blood eosinophilia was not noted. Parasitologic studies were negative. Histologic examination of segment of jejunum showed heavy transmural infiltration of eosinophils which were extended to subserosal layer. Eosinophilic ascites noted in eosinophilic gastroenteritis, though not a common disease entity, had not been described in the laboratory medicine related papers in Korea. Therefore we report this case as an example of eosinophilic ascites.
Abdominal Pain ; Adult ; Ascites* ; Diarrhea ; Eosinophilia ; Eosinophils* ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Hypereosinophilic Syndrome ; Jejunum ; Korea ; Nausea ; Parasitic Diseases ; Rare Diseases ; Vasculitis ; Vomiting ; Weight Loss

BACKGROUND: Detection of malignant effusion is important task in the routine laboratory work. However, in clinical laboratory where only Wright-Giemsa stained slides are examined it is not easy. So the author proposed a scoring system in the differential diagnosis of malignant effusion using the results of routinely tested items. METHODS: 61 samples of exudates (13 ascites, 48 pleural fluids) from 47 patients were included. The scores are summed based on the routine laboratory results. Items were as follows: protein concentration, dominancy of lymphocyte (lymphocyte count over 50%) and morphologic variety of lymphoid cells, mesothelial cell count, eosinophil count, and presence of tumor cells. Total summed full scores would be 8 points. RESULTS: The summed scores of 14 samples of malignant effusion were as follows: 7 points in 2 cases, 6 points in 1 case, 5 points in 8 cases, 4 points in 3 cases, with the mean score of 5.1 points. The 47 benign exudates showed 4 points in 1 case, 3 points in 4 cases, 2 points in 33 cases, 1 point in 9 cases, with the mean score of 1.9 points. If malignancy were postulated as summed score over 4 points, a statistically significant difference was observed between the summed score and effusion type (P<0.0001). CONCLUSIONS: Two groups of effusion can be distinguished: one group that showed more than 4 points, with malignant potential and the other group lower than 3 points with benign effusion. In case with high score, 4 points above, one should pay attention to the presence of malignant cells and even if tumor cells were not found, the possibility of malignant condition should be notified.
Ascites ; Cell Count ; Diagnosis, Differential ; Eosinophils ; Exudates and Transudates ; Humans ; Lymphocytes

Unusual morphology of aberrant forms of bacteria, presented with grotesque-giant form, 15 m 3 m, with central emptiness and fusiform ends was observed in urine Gram stain from a 26-year-old woman who was admitted with the symptoms of acute urinary tract infection. On wet smear, these bacilli were markedly swollen, yeast-like organisms. In addition to normal shaped bacilli, various shapes of another aberrant bacteria, such as long bacilli, filamentous form, filamentous form with central bulge, and bipolar staining with central emptiness were also observed in the same specimen. The morphologic characteristics of these unusual aberrant bacilli were more distinct on Papanicolaou stain than on Gram stain. In Korea, where antimicrobial agents are overused and disused, the frequency of observing the aberrant bacteria would be much higher than cases reported. Here we report unusual morphology of aberrant forms of Escherichia coli with the emphasis on awaring of the potential appearance of such bacilli in clinical specimen and avoiding confusion with fungi and other naturally filamentous organisms.
Adult ; Anti-Infective Agents ; Bacteria* ; Escherichia coli ; Female ; Fungi ; Humans ; Korea ; Urinary Tract Infections

We found an unusual morphology of eosinophil nucleus having longer chromatin filament in addition to a single narrow chromatin bridge. The nucleus having two chromatin filament bridge looked like two legged eosinophil, instead of usual glasses shape. As the physiologic function of the nucleus of granulocyte segmentation and the mechanism by which the lobes are formed during differention is still unknown, we could not know the definite nature and significance of these double chromatin filament. However we could suggest that they may be a reactive change of eosinophilia. This not uncommon morphology has not been described as yet. Here we report three cases of unusual morphology of eosinophil nucleus presenting double chromatin filament bridge, one case with a band form nucleus looked like ring shape, with brief review of literatures.
Chromatin* ; Eosinophilia ; Eosinophils* ; Eyeglasses ; Glass ; Granulocytes ; Leg

BACKGROUND: We incidentally found purple metachromatic globules looked like red blood cells in the blood smears of a leukemic patient for reticulocyte count. The metachromatic globules were various in size and shape. The stain solution of brilliant cresyl blue was degenerated to pH change of 3.5. To find out the nature of these metachromatic globules, this study was performed. METHODS: Reticulocyte count stain was performed on the slide smears with EDTA bloods, their plasma, and sera of leukemic patients and normal persons using the degenerated brilliant cresyl blue stain solution. To clarify the nature of the metachromatic globules, we also carried out immunocytochemical stain with monoclonal antibodies to fibronectin and fibrinogen on the same slide smears prepared. The pH of the stain solution checked. RESULTS: EDTA blood, plasma and human fibrinogen product showed the same metachromatic globules. But in serum smear the metachromasia was faint and globule shape was not noted. Purified human fibrinogen showed reticulated pattern metachromasia. Immunocytochemical stain with monoclonal antibody to the fibronectin showed small dot, round, budding, and globule form positivity in the smear of EDTA blood, plasma, and human fibrinogen product. Platelets also showed positive reaction. Purified human fibrinogen showed no positive reaction. Immunocytochemical stain with monoclonal antibody to the fibrinogen on the other hands showed reticulated pattern positivity in EDTA blood, plasma, human fibrinogen product and purified human fibrinogen. Smear with serum showed no positive reaction. The stain solution was degenerated to acidic pH of 3.5. CONCLUSIONS: Fibronectin, ubiquitous adhesive protein, was easily observed by simple stain method. Further study should be followed, however we suggest detection of plasma fibronectin which is costly, could be easily done by simple stain method.
Adhesives ; Antibodies, Monoclonal ; Edetic Acid ; Erythrocytes ; Fibrinogen ; Fibronectins* ; Hand ; Humans ; Hydrogen-Ion Concentration ; Plasma ; Reticulocyte Count

Damage to adjacent teeth is one of the various complications that may occur during implant placement and is often the result of improper direction during fixture placement or excessive depth of placement. In general, if detrimental symptoms, such as reaction to percussion in damaged teeth, mobility, and pulp necrosis, are not present, osseointegration should be observed at follow-up. In three cases, the possibility of root damage due to an implant fixture placed too close to each adjacent tooth was perceived on radiographs. However, in all of these cases, there were no clinical symptoms or radiographic changes present in the tooth, and the implants did not exhibit decreased stability or peri-implantitis. Therefore, we can carefully predict that the implant fixture close to the adjacent tooth did not invade the cementum of the root, and therefore did not produce the suspected pulpal damage or periradicular symptoms. In this study, we considered both the implant status as well as the adjacent tooth.
Dental Cementum ; Dental Implants ; Dental Pulp Necrosis ; Follow-Up Studies ; Osseointegration ; Percussion ; Peri-Implantitis ; Prognosis ; Tooth

OBJECTIVES: This study compared the impact of implant surface treatment on the stability and osseointegration of implants in dog mandibles. MATERIALS AND METHODS: Six adult dogs received a total of 48 implants that were prepared using four different surface treatments; resorbable blast media (RBM), hydroxyapatite (HA), hydrothermal-treated HA, and sand blasting and acid etching (SLA). Implants were installed, and dogs were separated into 2- and 4-week groups. Implant stability was evaluated via Periotest M, Osstell Mentor, and removal torque analyzers. A histomorphometric analysis was also performed. RESULTS: The stability evaluation showed that all groups generally had satisfactory values. The histomorphometric evaluation via a light microscope revealed that the HA surface implant group had the highest ratio of new bone formation on the entire fixture. The hydrothermal-treated HA surface implant group showed a high ratio of bone-to-implant contact in the upper half of the implant area. CONCLUSION: The hydrothermal-treated HA implant improved the bone-to-implant contact ratio on the upper fixture, which increased the implant stability.
Adult ; Animals ; Dental Implants ; Dogs* ; Durapatite ; Humans ; Mandible* ; Mentors ; Osseointegration* ; Osteogenesis ; Torque