Strumal carcinoma of the ovary is rare tumor of germ cell origin characterized by intimate mixture of thyroid tissue and carcinoid. We report a strumal carcinoid tumor associated with ipsilateral follicular cyst and contralateral mature cystic teratoma of the ovary in a 47-year-old woman. Histologically it was composed largely of trabeculae partly of insular carcinoid and focally of individual thyroid follicles. Many cells in the carcinoid areas and even some follicular areas contained abundant argyrophile granules, and they also, in the corresponding areas, demonstrated thyroglobulin. Electron microscopic findings revealed abundant neurosecretory granules and colloid material in the same cell. We agree that this tumor is derived from hybrid showing thyroid and neuroendocrine differenciation.
Female ; Humans ; Cysts

Sarcomatoid carcinomas are malignant epithelial neoplasms in which the tumor cells assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification of some true carcinomas as sarcomas. These spindle cells are malignant and manifest various amount of both vimentin and cytokeratin. Positive reaction of some of the spindle cells for cytokeratin antibodies is confirmatory. Clinical features do not differ significantly from those of patients with high-grade transitional cell carcinoma. So far, 13 cases of sarcomatoid transitional cell carcinoma of the renal pelvis have been reported in English and Korean literature. In this report, we describe clinicopathologic features of recently observed two cases of sarcomatoid transitional cell carcinoma of the renal pelvis and summarize the pathologic findings of previously reported cases with review of the literature.
Antibodies ; Carcinoma ; Carcinoma, Transitional Cell* ; Carcinosarcoma ; Classification ; Humans ; Keratins ; Kidney Pelvis* ; Sarcoma ; Vimentin

BACKGROUND: To determine the most effective method for detecting mycobacteria in formalin- fixed paraffin-embedded (FFPE) tissue, we compared the results of Ziehl-Neelsen stain (ZNS) and mycobacterial culture with those of polymerase chain reaction (PCR) and real-time quantitative PCR (RQ-PCR). METHODS: We analyzed 54 cases diagnosed as chronic granulomatous inflammation. In all cases, ZNS and nested PCR using three different primers, IS6110, Mpb64 and IS6110/Rpobeta were done. RQ-PCR with the IS6110/Rpobeta primer was done in 51 cases. RESULTS: Mycobacteria were identified by ZNS in 15/54 (27.8%) cases. RQ-PCR had the highest sensitivity (80.0%) compared to PCR with IS6110 (73.3%), Mpb64 (60.0%) and IS6110/Rpobeta (73.3%). Specificity was higher in all PCR experiments (79.5-82.1%) than in RQ-PCR (69.4%) experiments. The false negative rate was lowest for RQ-PCR (20.0%) than for PCR with IS6110 (26.7%), Mpb64 (40.0%) and IS6110/Rpobeta (26.7%). The false positive rate was highest for RQ-PCR (30.6%) compared to PCR with IS6110 (20.5%), Mpb64 (17.9%) and IS6110/Rpobeta (20.5%). CONCLUSIONS: RQ-PCR had the highest sensitivity, and the lowest false negative rate, but it also had a higher false positive rate than PCR for detection of mycobacteria in FFPE tissues.
Granulomatous Disease, Chronic ; Inflammation ; Mycobacterium ; Polymerase Chain Reaction ; Sensitivity and Specificity

OBJECTIVE: To evaluate the efficacy of prenatal multiplex PCR with chorionic villi, in the case of family history of DMD due to exon deletion. METHODS: DNA was extracted when cells' size are 1x 106 on T- flask surface area reach to 25 cm2 after 2 weeks from sex confirmation. Average DNA concentration was 50-100 ng and multiplex PCR test was performed from DNA extraction. RESULT: PCR was done for 17 exons devided into 4 groups. Seventeen exons were all amplified with their right size. CONCLUSIONS: This method is DNA analysis for prenatal diagnosis of DMD with chorionic villi in the family of DMD. This is useful when preimplantation genetic diagnosis is not available.
Chorion* ; Chorionic Villi* ; DNA ; Exons ; Humans ; Multiplex Polymerase Chain Reaction* ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction ; Preimplantation Diagnosis ; Prenatal Diagnosis*

Non-invasive positive pressure ventilation (NIPPV) was mainly applied to acute respiratory failure in chronic obstructive pulmonary disease (COPD) and to intrinsic lung disease such as neuromuscular disorders. It has been reported that this maneuver reduces morbidity, mortality and hospital stay in patients in the intensive care unit. We observed a 32-year-old female renal transplantation patient who developed pulmonary edema during the perioperative state. The mainteance of an endotracheal tube in intubated patients who were on immunosuppresive therapy might increase nosocomial pneumonia significantly. In this case, the mortality increase was expected, therefore we considered that early extubation and mask continuous positive airway pressure (mask CPAP) could help. By using mask CPAP, the patient showed a good response and the pulmonary edema was improved. We report a case about the benefits of NIPPV in the treatment of pulmonary edema in an immunosuppressed patient of which the result was very satisfactory.
Adult ; Continuous Positive Airway Pressure ; Female ; Humans ; Intensive Care Units ; Kidney Transplantation ; Kidney* ; Length of Stay ; Lung Diseases ; Masks ; Mortality ; Pneumonia ; Positive-Pressure Respiration* ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Edema* ; Respiratory Insufficiency

Intracystic papillary carcinoma(IPC) of the breast is a distinctive and very rare variant of intrductal carcinoma. The cytologic features of IPC have been rarely reported, and there are difficulties in distinguishing between benign and malignant papillary breast lesions. Herein we report a IPC of the breast in a 80 year-old female. Fine needle aspiration cytology revealed monotonous cuboidal epithelial cells in small clusters and individually scattered on bloody background. The tumor cells did not show overt cytologic atypia. With the histologic features of this case and review of the literature, the cytologic differential points are discussed.
Aged, 80 and over ; Biopsy, Fine-Needle* ; Breast* ; Carcinoma, Papillary* ; Epithelial Cells ; Female ; Humans

It is well known that fine needle aspiration biopsy(FNAB) is very useful and has a high accuracy rate in the diagnosis of renal neoplasms. Although there is some indecision to perform the FNAB for a rare possibility of tumor seeding along the biopsy needle tract, it tends to be used increasingly. As in the cytologic diagnosis of metastatic lesion through out the body, renal cell carcinoma should nearly always be considered in the differential diagnosis, the precise understainding of cytologic features of renal cell carcinoma with various cell types and architectural patterns is necessarily required. In this report, we present three cases of primary renal cell tumors, two of renal cell carcinomas and one of oncocytoma, preponderantly emphasizing the cytologic differential points in the FNAB specimen.
Adenoma, Oxyphilic* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Renal Cell* ; Diagnosis ; Diagnosis, Differential ; Kidney Neoplasms ; Needles

BACKGROUND: IgA nephropathy (IgAN) is the most common glomerulonephritis worldwide, and the clinical course of IgAN shows marked variability. Many efforts have made to histologically predict the clinical outcome. There are two methods to classify IgAN. One is mainly based on the glomerular changes, such as the WHO and the Lee and Haas classification systems. The other is a morphologic semi-quantitative scoring system, which counts the changes of the glomerular, tubulointerstitial and vascular structures, respectively. The purpose of this study is to determine whether the WHO classification properly reflects the various morphologic findings of IgAN. METHODS: We analyzed 354 cases of IgAN by both the WHO classification system and the semiquantitative scoring system and evaluated the correlations of these two methods. RESULTS: The severity of the glomerular lesions (glomerulosclerosis, capsular adhesion and mesangial matrix expansion) and the tubulointerstitial lesions (interstitial fibrosis, tubular atrophy and interstitial lymphocytic infiltration) are strongly correlated with the increase of the WHO classes of IgAN (Spearman's rho [R] > or =0.5, p<0.05). There is a weak correlation between crescent formation and the increase of the WHO classes (R=0.3, p<0.05). CONCLUSIONS: This study shows that the WHO classification well reflects the severity of various morphologic findings and this suggests a complementary role for the semi-quantitative scoring system in classifying IgAN.
Atrophy ; Fibrosis ; Glomerulonephritis ; Glomerulonephritis, IGA ; Immunoglobulin A

BACKGROUND: C1q nephropathy (C1qN) is a controversial diagnostic entity defined by Jennette and Hipp in 1985. The prevalence is very low and a few large scale studies have been reported. Application of the criteria for clinical diagnostics of C1qN may cause confusion with other glomerulonephropathies, such as minimal change disease (MCD) or focal segmental glomerulosclerosis (FSGS). In order to clarify the confusion with glomerulonephropathies, we did this study to identify the clinicopathological characteristics and the exact disease entity of C1qN. METHODS: A total of 5,258 kidney biopsies at Kangnam St Mary's Hospital were reviewed. Twenty three cases (0.44%) met the criteria of C1qN. Twenty eight cases showing dominant C1q deposits without electron dense depostis (EDD) grouped as C1q+EDD-, and previously diagnosed typical cases of MCD and FSGS were selected for this study. Four groups were compared to each other with regard to the clinical and pathological aspects of the disease. RESULTS: C1qN patients had an average age of 30.4 years. Eighteen were males and 5 were females. Eighty seven percent had proteinuria and 18% had hematuria. By electron microscopy analysis, 100% had mesangial EDD and 47.8% showed foot process effacement. C1qN had some significant differences compared with C1q+EDD-, MCD and FSGS. CONCLUSIONS: C1qN is clinically and morphologically different from MCD and FSGS. However, additional long term studies are needed to fully define C1qN from other glomerulonephritis with C1q deposits.
Biopsy ; Complement C1q ; Corneal Dystrophies, Hereditary ; Electrons ; Female ; Foot ; Glomerulonephritis ; Glomerulosclerosis, Focal Segmental ; Hematuria ; Humans ; Kidney ; Male ; Microscopy, Electron ; Nephrosis, Lipoid ; Phenanthridines ; Prevalence ; Proteinuria

OBJECTIVES: This study was performed to investigate the mumps transmission control status and inapparent infection rate among middle and high school students in Daegu City during a mumps outbreak. METHODS: Nine schools (two middle schools and seven high schools), which reported a number of mumps cases between 2007 and 2008 were selected for investigation. During March-May 2008, a standard questionnaire was distributed to gather information about case identification, instructed isolation measure, isolation status of mumps cases and related factors, and outdoor activities of non-isolated mumps case. Inapparent infection rate was estimated by serum mumps IgM and IgG antibodies status and self-reported mumps symptoms in three of the nine schools. RESULTS: Among 2,560 respondents, more than half of students answered that they did not receive instructions in mumps transmission control measures during the outbreak. Among the 327 mumps cases identified by the questionnaire, 131 cases (40.1%) were considered as isolated and the isolation rates were significantly different among schools, grades, and gender. Of the non-isolated cases, 88.3% continued attending school. Inapparent mumps infection rates were between 56.3% and 70.2%. CONCLUSIONS: Mumps transmission control was inadequate to control the mumps outbreak. Although high inapparent infection rate would mitigate the transmission control effect of case isolation, this measure is fundamental for infection control. The reasons of this inadequate status need to be explored to develop an effective intervention strategy.
Adolescent ; Child ; Communicable Disease Control/*methods ; Disease Outbreaks/*statistics & numerical data ; Female ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Male ; Mumps/epidemiology/*prevention & control/transmission ; Patient Isolation ; Questionnaires ; Republic of Korea/epidemiology ; Schools/*statistics & numerical data ; Students