The cystic hypersecretory duct carcinoma of the breast was first described in 1984 by Rosen and Scott and warrants separate discussion because of its unusual pathological features. It is morphologically distinguishable from juvenile (secretory) carcinoma and from mucinous (colloid) carcinoma or mucocele-like tumor. We present a case report of intraductal cystic hypersecretory carcinoma of the breast with hormone receptor and oncogene study. The histologic differential diagnosis, with an emphasis on benign lesions that may have a predominant cystic component, is also discussed.
Breast Neoplasms ; Breast* ; Diagnosis, Differential ; Mucins ; Oncogenes

To evaluate whether different qualifications of a cytologic diagnosis of "atypical squamous cells of undetermined significance(ASCUS)" predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as "favor reactive"(25%), "favor low grade squamous intraepithelial lesion (LSIL)"(24%), "favor squamous intraepithelial lesion(SIL)"(16%), "favor high grade squa mous intraepithelial lesion(HSIL)"(16%), and "not otherwise specified"(19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the "favor reactive", 27% in "favor LSIL", 70% in "favor SIL", 75% in "favor HSIL", and 35% in "not otherwise specified" smears. There were significant asso ciations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, most of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of "ASCUS, favor LSIL" circumspectly.
Biopsy* ; Cervix Uteri ; Diagnosis* ; Female ; Humans ; Papanicolaou Test

Recently, the incidence of fungal infection increases because of immunosuppressive therapy and chemotherapy. In immunosuppressed transplant recipients, Aspergillus can be a dangerous pathogen, capable of inducing fulminant clinical disease. Invasive fungal infections are life-threatening complications in solid-organ transplantation. Although the rate of fungal infections in transplant recipients is lower than that of other infections, the mortality rate is higher. A 34 year-old male was admitted to our hospital with fever and gross hematuria. He had received renal transplantation 2 years ago and had been transferred the other hospital 1 month ago. Initial laboratory data evaluation showed a pancytopenia and azotemia. We thought that pancytopenia was caused by immunosuppressive agents and infection. The patient was treated with antibiotics but fever was not subsided. After 4 days, he complained of transplant site pain and tenderness to percussion. A percutaneous renal biopsy was performed. Microscopic examination showed invasive aspergillosis in transplanted kidney and perirenal area. We removed the transplanted kidney and perirenal tissue, and prescribed antifungal agents for 3 months.
Anti-Bacterial Agents ; Antifungal Agents ; Aspergillosis ; Aspergillus ; Azotemia ; Biopsy ; Fever ; Hematuria ; Humans ; Immunosuppressive Agents ; Incidence ; Kidney ; Kidney Transplantation ; Male ; Pancytopenia ; Percussion ; Transplants

BACKGROUND: Atopic dermatitis (AD) is a common inflammatory skin disease. Atopic dermatitis is associated with increased IL-4, IL-5, IL-10 and IL-13 but decreased INF-gamma and TNF production. IL-10 production has been implicated in autoimmunity because of its effect on B-cell proliferation and antibody production. The study of IL-10 gene polymorphism is of interest because of the pivotal role of IL-10 in the regulation of inflammatory and immune responses. TNF-beta significantly upregulates INF-gamma but downregulates IL-5, IL-13 and IgE, which suggests a potential role of TNF-beta in the pathogenesis of atopic dermatitis. OBJECTIVES: We have investigated polymorphism of IL-10 promoter gene and TNF-beta gene. METHODS: Seventy one patients with atopic dermatitis and one hundred and sixty six normal subjects participated in this study with analysis of polymorphism of IL-10 promoter (-1082), (-819) gene and seventy one patients with atopic dermatitis and one hundred and forty one normal subjects participated in the analysis of polymorphism of TNF-beta gene. The patients in this study were recently diagnosed with atopic dermatitis. RESULTS: The frequency of IL-10 promoter (-1082) genotypes (A/A, A/G, G/G), genes (A, G), IL-10 promoter (-819) genotypes (T/T, T/C, C/C) and genes (T, C) did not show any significant difference between atopic dermatitis patients and normal controls. There was no significant difference in the frequency of TNFB genotypes (TNFB*1/TNFB*1, TNFB*1/TNFB*2, TNFB*2/TNFB*2) and genes (TNFB*1, TNFB*2) in patients of atopic dermatitis and normal controls. CONCLUSION: The results of this study suggest that the other regions of the IL-10 promoter gene and TNFB gene should be investigated for polymorphism of atopic dermatitis. And the difference of IL-10 promoter and TNFB gene polymorphism between caucasian and Korean needs to be evaluated.
Antibody Formation ; Autoimmunity ; B-Lymphocytes ; Dermatitis, Atopic* ; Genotype ; Humans ; Immunoglobulin E ; Interleukin-10* ; Interleukin-13 ; Interleukin-4 ; Interleukin-5 ; Lymphotoxin-alpha* ; Polymorphism, Genetic* ; Skin Diseases

Systemic lupus erythemotosus (SLE) is an autoimmune disorder with dermal, renal, and cardiac manifestations. It frequently has cardiovascular complications such as pericarditis, myocarditis, and valvular heart diseases. Valvular heart diseases in SLE comes mainly in the form of mitral or aortic insufficiencies. Report of aortic stenosis is extremely rare. Surgical treatments of valvular heart disease in SLE are not done frequently because of complications in other organs. Aortic stenosis developed in a 59 year-old woman with SLE, and aortic valve replacement was done successfully.
Aortic Valve ; Aortic Valve Stenosis* ; Endocarditis ; Female ; Heart Valve Diseases ; Humans ; Lupus Erythematosus, Systemic* ; Middle Aged ; Myocarditis ; Pericarditis

Ocular sebaceous carcinoma (OSC) is an uncommon malignancy with a potential to recur and metastasize. Some characteristics of sebaceous carcinoma, such as female preponderance, shown in the present series during 11-year period at Korea Cancer Center Hospital, led us to study their hormone receptors and c-erbB-2 expression. c-erbB-2 overexpression was very common (83%) in OSC, and was not associated with pathologic findings or clinical outcome. Interestingly, estrogen and progesterone receptor was detected in 4 and 2 cases, respectively, suggesting a role of hormonal influence on this neoplasm. Immunohistochemical and clinicopathologic features of 18 cases of OSC in Korea are presented.
Adult ; Aged ; Aged, 80 and over ; Carcinoma/pathology* ; Carcinoma/metabolism ; Carcinoma/chemistry ; Eyelid Neoplasms/pathology* ; Eyelid Neoplasms/metabolism ; Eyelid Neoplasms/chemistry ; Female ; Human ; Immunohistochemistry ; Male ; Middle Age ; Necrosis ; Receptor, erbB-2/biosynthesis* ; Receptor, erbB-2/analysis ; Receptors, Estrogen/analysis ; Receptors, Progesterone/analysis ; Sebaceous Gland Neoplasms/pathology* ; Sebaceous Gland Neoplasms/metabolism ; Sebaceous Gland Neoplasms/chemistry

Burkitt's lymphoma is a type of non-Hodgkin's lymphoma occurring predominantly in children. In some cases, the first manifest site is the jaw, and the disease may be misdiagnosed as an infectious disease. A case of a 12-year-old boy with a painful swelling on the right retromolar triangle area is presented. At the time of the first visit, it was misdiagnosed as an osteomyelitis. Included are several characteristics and differential diagnosis of this disease.
Burkitt Lymphoma* ; Child ; Communicable Diseases ; Diagnosis, Differential ; Humans ; Jaw ; Lymphoma, Non-Hodgkin ; Male ; Mandible* ; Osteomyelitis

A 52-year-old woman was referred to our hospital due to chronic renal failure with a 10-year history of hypertension. We found polycystic kidney disease, pulmonary tuberculosis and an aldosterone-producing adrenocortical mass. At this time, her serum potassium level and blood pressure were within the normal range. She refused hemodialysis and then was hospitalized because of uremic encephalopathy. On admission, her serum potassium level was normal without treatment and plasma aldosterone concentration highly elevated. She received hemodialysis, and thereafter hypokalemia developed. We then administered spironolactone, whereupon serum potassium level returned to the normal range. In this case, we thought that normokalemia was balanced hypokalemia of primary aldosteronism with hyperkalemia of chronic renal failure, and that hypokalemia developed after hemodialysis was due to an imbalanced primary aldosteronism with end stage renal disease.
Aldosterone ; Blood Pressure ; Female ; Humans ; Hyperaldosteronism* ; Hyperkalemia ; Hypertension ; Hypokalemia ; Kidney Failure, Chronic* ; Middle Aged ; Plasma ; Polycystic Kidney Diseases ; Potassium ; Reference Values ; Renal Dialysis ; Spironolactone ; Tuberculosis, Pulmonary

The Korean Central Cancer Registry Program analyses data on the incidence and characteristics of cancer gathered from training hospitals across the nation in order to prepare coherent and accurate summary. The program has had these data computer processed through CANCER (version 1.5), a computer program for registry, since 1996. In 2002, we conducted a survey of the registered hospitals on the status of utilization for this cancer registry related-computer program and on the additional requirements to the existing variables. The results showed that the number of hospitals using the CANCER program has slightly outnumbered the hospitals using their own computer system for hospital information. That is because the number of cancer registry cases of the large-scale hospitals such as general hospitals, which comprises the majority of registered hospitals, is so many that they are able to sort out cancer registry data from their own system. They also reported a middle level of satisfaction with the program utilization. Among the least satisfactory items were the program's lack of portability to different situations and the necessity for double input of the same registry field. The field most requested by the surveyed hospitals for addition to the program was one on metastatic site. This study should lead to follow-up measures such as the development of a variety of algorithms to enhance the accuracy of the data by further reducing the errors in processing the data, and the recommendation of standards which are likely to enhance data adaptability. The result will be utilized as a basic reference for building a systematic and effective database on the national cancer registry.
Computer Systems ; Hospitals, General ; Incidence ; Korea*

Incidence of renal involvement in mixed connective tissue disease (MCTD) is low. In the presence of glomerulonephritis, membranous nephropathy (MN) in MCTD is common. A 47-year-old woman presented with hypothyroidism. She developed Raynaud's phenomenon, arthralgia, and incomplete lupus erythematosus, diagnosed with MCTD. One year after then, the patient developed persistent proteinuria (1+) without hematuria. Following diagnosis with MCTD, her renal function began to deteriorate. The renal biopsy showed late stage MN. For the treatment of MN with mild proteinuria and MCTD, we prescribed an angiotensin II receptor blocker and 7.5 mg of methotrexate per week and 300 mg of hydroxychloroquine daily. The patient had a reduced estimated glomerular filtration rate of 55% for the subsequent eight years. The MN in MCTD is known to show good renal prognosis. Here, we report on a rare case of MN in MCTD in Korea with a bad prognosis.
Arthralgia ; Biopsy ; Diagnosis ; Female ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, Membranous* ; Hematuria ; Humans ; Hydroxychloroquine ; Hypothyroidism ; Incidence ; Korea ; Methotrexate ; Middle Aged ; Mixed Connective Tissue Disease* ; Prognosis* ; Proteinuria ; Receptors, Angiotensin