We evaluated the availability of toluidine blue stain in body fluids, such as peritoneal and pleural fluid and urine. Nine hundreds specimens, i.e., 400 pleural and 400 peritoneal fluids and 100 urine samples, respectively, from Jan. 1995 to May 1996 were included. We obtained the result of high sensitivity and high specificity in toluidine blue stained body fluid in comparison with Papanicolaou stained result. Additionally, we found the diagnostically important crystals in chylothorax and some urine samples, which can not be seen in routine Papanicolaou stain. We thought the toluidine blue stain in body fluid is one of very useful diagnostic methods.
Ascitic Fluid ; Body Fluids ; Chylothorax ; Proteinuria* ; Sensitivity and Specificity ; Tolonium Chloride

Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained. We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically. The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round, centrally located nuclei with single, prominent acidophilic mucleoli. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.
Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Cytoplasm ; Diagnosis ; Endothelial Cells ; Humans ; Korea* ; Liver Diseases ; Middle Aged ; Neoplasm Metastasis ; Prevalence* ; Sacrum

A case of metastatic adenoid cystic carcinoma of the lung, originated from the trachea, was diagnosed by fine needle aspiration. Although the cytologic features of adenoid cystic carcinoma have been well described, it is easy to confuse adenoid cystic carcinoma with more common primary small cell neoplasms of the lung, i.e., small cell carcinoma, well differentiated adenocarcinoma, and carcinoid tumor of the lung. The features distinguishing adenoid cystic carcinoma from these neoplasms include 1) tight, globular, honeycomb pattern of cells, 2) acelluair basement membrane material in the lumen, and 3) cells lacking true nuclear molding and having bland chromatin pattern. The mcrphologic feature of metastatic adenoid cystic carcinoma in this case was so distinctive as to permit a definite diagnosis by aspiration cytology.
Adenocarcinoma ; Basement Membrane ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carcinoma, Adenoid Cystic ; Carcinoma, Small Cell ; Chromatin ; Diagnosis ; Fungi ; Kidney* ; Lung ; Trachea

Hepatoblastoma (HB) is a rare embryonic malignant tumor of the liver. Most morphological studies on HB have limited to the histological characteristics and only 3 cases of HB have been described in the cytology literature. We present 2 cases of HB occurring in children aged 1 year and 3 years, respectively. The distinctive cytologic features of fine needle aspiration of HB were clusters of tumor cells showing acinar and trabecular pattern, smaller tumor cells with a high nuclear-cytopalsmic ratio and hyperchromatic nuclei having prominent nucleoli, and the presence of extramedullary hematopoiesis and osteoid material. These features were also found in the cell block and the biopsy specimen, and appeared very useful in the differentiation of HB from hepatocellular carcinoma.
Acute Kidney Injury* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular ; Child* ; Hematopoiesis, Extramedullary ; Hepatoblastoma ; Humans ; Liver ; Nephrosis, Lipoid*

Herpes simplex virus type 1 and 2 (HSV-1, HSV-2) are the ubiquitous human pathogens responsible for a variety of afflictions. HSV-2 is one of the viruses that were suspected of promoting carcinogenesis in the uterine cervix. Certainly, there is a need for the more sensitive and accurate laboratory techniques for HSV detection. We examined total 80 cases of smears including 17 Tzanck smears of skin and 63 cases of Papanicolaou smears from total 77 patients with clinical impression of herpetic infections, from September, 1985 through August, 1989. Immunohistochemical typings for HSV-1 and HSV-2 were performed together with routine cytologic findings and compared. The results are as follows ; 1) Patients were 9 males and 33 females, and age distribution was between 5 and 71 years 2) Subjective symptoms such as ulceration, vesicle, vaginal discharge, pruritus, and pain were complained in 36 patients and 38 cases were genital herpes. Recurrence was noted in 11 cases. 3) Positive results were obtained in 42 among 80 cases. 4) Both routine cytology and immunohistochemical staining were positive in 13 cases and in 24 cases only immunohistochemical staining were positive. 5 cases were positive only in routine cytologic smears. 5) The cases that immunocytochemical stain had been performed were 37 cases, which were all positive in type 2. Among the above 37 cases, type 1 also were positive in 5 cases. The results show that the immunoperoxidase technique is one of the rapid and reliable method to confirm the herpetic when suspected and that it is particularly useful when the Papanicolaou smear findings are equivocal.
Age Distribution ; Carcinogenesis ; Cervix Uteri ; Female ; Herpes Genitalis ; Herpesvirus 1, Human ; Herpesvirus 2, Human ; Humans ; Immunoenzyme Techniques ; Male ; Papanicolaou Test ; Pruritus ; Recurrence ; Skin ; Ulcer ; Urinary Calculi* ; Vaginal Discharge

A case of multiple myeloma with massive pleural effusion is reported. A 53 year-old previous known multiple myeloma patient vistited our hospital complaining of cough with sputum. Radiologic study revealed multiple osteolytic bony lesions and left side pleural effusion. The effusion were bloody exudates containing numerous atypical plasma cells. The tumor cells showed pleomorphism, eccentric nuclei, prominent nucleoli, perinuclear halo, multincleation, and chromatin patterns of occasional cart-wheel appearance. The cytological examination of pleural fluid established the malignant nature of the effusion with multiple myeloma.
Biopsy* ; Chromatin ; Cough ; Enzyme Assays* ; Exudates and Transudates ; Glycogen Storage Disease* ; Glycogen* ; Humans ; Lung ; Lymphoma, T-Cell, Peripheral ; Middle Aged ; Multiple Myeloma ; Plasma Cells ; Pleural Effusion ; Sputum

PURPOSE: Brain metastasis is estimated to occur in 20 to 40% of cancer patients, and meningeal involvement has been reported in 5% to 8% of cancer patients. Even if the prognosis is grave, standard treatment modality of brain metastasis or leptomeningeal carcinomatosis has not been established. We evaluated the prognosis and the clinical features of the brain and leptomeningeal metastasis of the breast cancer. MATERIALS AND METHODS: The 43 patients who was diagnosed as brain parenchymal metastasis or leptomeningeal carcinomatosis clinically, radiologically and/or cytologically were included in this study. The median age was 44(range: 27-61) years. RESULTS: The median duration from brain metastasis to death was 181 days(range: 8~1599), and the median duration from leptomeningeal carcinomatosis to death was 39 days(range: 25~152). Age(p=0.7174) and number of brain metastatic lesion(p=0.4097) did not influence the survival, but the presence of other systemic metastatic lesion affected the survival(p 0.0224). When we compared the survival rates of patients according to treatment modality, the patients with systemic chemotherapy versus patients without systemic chemotherapy showed differences(p= 0.0009). Patients treated with whole brain radiation only versus patients with whole brain radiation and other systemic management also showed different survival rate(p=0.0009). But intrathecal chemotherapy had no effect on survival. Well differentiated, solitary lesions were treated by operation and/or gamma-knife surgery, and their effects were good. CONCLUSION: Prolongation of survival was suggested with whole brain radiotherapy combined with systemic treatment in brain or leptomeningeal metastasis. Further study is expected to confirm this finding.
Brain* ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Meningeal Carcinomatosis* ; Neoplasm Metastasis* ; Prognosis ; Radiotherapy ; Survival Rate

Head and neck cancers have never been systematically studied for clinical purposes yet in Korea. This epidemiological survey on head and neck cancer patients was undertaken from January to December 2001 in 79 otorhinolaryngology resident-training hospitals nationwide. The number of head and neck cancer patients was 1,063 cases in the year. The largest proportion of cases arose in the larynx, as many as 488 cases, which accounted for 45.9%. It was followed by, in order of frequency, oral cavity (16.5%), oropharynx (10.0%), and hypopharynx (9.5%). The male:female ratio was 5:1, and the mean age was 60.3 yr. Surgery was the predominant treatment modality in head and neck cancers: 204 (21.5%) cases were treated with only surgery, 198 (20.8%) cases were treated with surgery and radiotherapy, 207 cases (21.8%) were treated with combined therapy of surgery, radiotherapy, and chemotherapy. Larynx and hypopharynx cancers had a stronger relationship with smoking and alcohol drinking than other primary site cancers. Of them, 21 cases were found to be metastasized at the time of diagnosis into the lung, gastrointestinal tract, bone, or brain. Coexisting second primary malignancies were found in 23 cases. At the time of diagnosis, a total of 354 cases had cervical lymph node metastasis accounting for 42.0%.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/epidemiology ; Carcinoma, Squamous Cell/epidemiology* ; Child ; Female ; Head and Neck Neoplasms/epidemiology* ; Health Surveys ; Human ; Korea/epidemiology ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasms, Second Primary/epidemiology ; Occupations ; Registries/statistics & numerical data ; Risk Factors ; Smoking/epidemiology

OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of mirtazapine treatment in multicenter population consisting of Korean patients suffering from moderate-to-severe depression. METHODS: Total 163 of in and outpatients with a diagnosis of major depressive disorder (DSM-IV) and 18 or over scores of 17-items Hamilton Rating Scale for Depression (HAMD) received treatment with mirtazapine (15-45 mg/day) for 6 weeks. Efficacy was assessed by HAMD, Montgomery and Asberg Depression Rating Scale (MADRS), Beck's Depression Inventory (BDI), and Clinical Global Impression (CGI) scales and statistical analyses were performed on the intent-to-treat sample (143 patients) using the last-observation-carried-forward method. In addition, reported adverse events, routine laboratory parameters, and vital signs were investigated to evaluate the safety of mirtazapine. RESULTS: Mean daily dose of mirtazapine was 28.4 mg. At the end of the study, the response rate (50% or more reduction from baseline in HAMD scores) was 75.5% and the remission rate (7 or less in HAMD score) was 42.7%. Mirtazapine treatment induced significant reduction in depressive symptoms at the 4(th) day and substantial reduction along the treatment period, as assessed by changes in HAMD, MADRS, BDI, and CGI scales. At the 4(th) day and first week of mirtazapine treatment, the mean HAMD-17 total score was significantly reduced compared that of the baseline and the response rates were 11.9% and 28.7%, respectively. Mirtazapine was well tolerated in general, and somnolence and sedation were the most common adverse events reported. In addition, there were no clinically relevant changes in laboratory parameters and vital signs, although body weight was increased. CONCLUSION: Although this trial had many limitations of open non-comparative study, mirtazapine was demonstrated to an effective treatment for moderate to severe major depressive disorder and was well tolerated. A potentially rapid onset of overall therapeutic efficacy of mirtazapine was suggested by significant changes in all major variables of efficacy after 4(th) day of treatment.
Body Weight ; Depression ; Depressive Disorder, Major ; Diagnosis ; Humans ; Outpatients ; Vital Signs ; Weights and Measures